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Intractable pediatric chronic sinusitis with antrochoanal polyp
1Department of Otolaryngology, Fukui Medical University, Matsuoka-cho, Yoshida-gun, 910-1193, Fukui, Japan. hisaito@fmsrsa.fukui-med.ac.jp
Insights
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.
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.
- 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.
Abstract:
It has been reported that pediatric chronic sinusitis with antrochoanal polyp is difficult to cure because it tends to recur easily even with surgery. Therefore, in order to improve its cure rate, aggressive treatment combining polypectomy, intra-maxillary intubation through the inferior meatus, macrolide administration, etc., was attempted. Thirty-seven sides of pediatric chronic sinusitis with antrochoanal polyp and 44 sides of chronic sinusitis without polyp were evaluated after the same treatments. The mean age of patients was 9.7 years, and the mean intubation period was 20 months. Since subjective improvements in children are questionable, the efficacy was evaluated strictly on the basis of X-ray alone focusing on the maxillary sinus. Twenty-four percent of the group with antrochoanal polyp showed 'excellent' effect, i.e. almost complete resolution of the sinus findings, while 45% of the group without polyp showed 'excellent' effect, with a mean follow-up period of 3 years and 6 months. This difference was significant (P<0. 01, chi(2)-test). These results further document the intractableness of chronic sinusitis with choanal polyp in children.