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Intractable pediatric chronic sinusitis with antrochoanal polyp.

H Saito1, N Honda, T Yamada

  • 1Department of Otolaryngology, Fukui Medical University, Matsuoka-cho, Yoshida-gun, 910-1193, Fukui, Japan. hisaito@fmsrsa.fukui-med.ac.jp

International Journal of Pediatric Otorhinolaryngology
|September 1, 2000
PubMed
Summary

Pediatric chronic sinusitis with antrochoanal polyp is challenging to treat and prone to recurrence. Aggressive treatment showed less efficacy in patients with polyps compared to those without, highlighting the difficulty in curing this condition.

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Area of Science:

  • Otolaryngology
  • Pediatric Medicine
  • Rhinosinusitis Research

Background:

  • Pediatric chronic sinusitis with antrochoanal polyp presents a significant treatment challenge due to high recurrence rates post-surgery.
  • Effective management strategies are needed to improve cure rates and reduce the impact of this condition on children's health.

Purpose of the Study:

  • To evaluate the efficacy of an aggressive treatment protocol for pediatric chronic sinusitis with antrochoanal polyp.
  • To compare treatment outcomes in children with and without antrochoanal polyps.

Main Methods:

  • An aggressive treatment combining polypectomy, intra-maxillary intubation, and macrolide administration was applied.
  • Thirty-seven cases of pediatric chronic sinusitis with antrochoanal polyp and 44 cases without polyps were evaluated.

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  • Efficacy was assessed using X-ray imaging of the maxillary sinus, focusing on resolution of sinus findings.

    • Main Results:

    • The group with antrochoanal polyps achieved an 'excellent' effect in 24% of cases, compared to 45% in the group without polyps.
    • A significant difference (P<0.01) in treatment efficacy was observed between the two groups.
    • The mean follow-up period was 3 years and 6 months, with a mean intubation period of 20 months.

    Conclusions:

    • Chronic sinusitis with antrochoanal polyp in children is a difficult-to-treat condition with a tendency for recurrence.
    • The aggressive treatment protocol demonstrated significantly lower efficacy in resolving sinus findings in children with antrochoanal polyps.
    • Further research into novel therapeutic approaches is warranted for intractable pediatric chronic sinusitis with choanal polyp.