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[Two cases of paranasal sinusitis with choanal polyp in children]
E Yumoto1, K Yamagata, T Shinohara
1Department of Otolaryngology, School of Medicine, Ehime University.
Insights
Functional endoscopic sinus surgery (FESS) effectively treats pediatric choanal polyps and sinusitis. This minimally invasive approach preserves the maxillary sinus, showing no recurrence one year post-operation in two young patients.
Area of Science:
- Otolaryngology
- Pediatric Surgery
- Rhinology
Background:
- Choanal polyps frequently coexist with ipsilateral maxillary sinusitis.
- Traditional treatments like Caldwell-Luc operation may involve extensive maxillary sinus manipulation.
- Pediatric patients require surgical techniques that prioritize sinus preservation.
Observation:
- Two pediatric cases of choanal polyp with sinusitis were surgically managed.
- One patient underwent osteoplastic maxillary operation and FESS; the other had FESS alone.
- Both cases involved polyps originating from the middle turbinate or maxillary sinus.
Findings:
- One-year follow-up revealed no polyp recurrence in either patient.
- Both patients demonstrated restored maxillary sinus aeration and healthy mucosa post-surgery.
- Functional endoscopic sinus surgery (FESS) proved effective in both pediatric cases.
Implications:
- FESS offers a viable, conservative surgical option for pediatric choanal polyps.
- Minimally invasive techniques like FESS can achieve excellent outcomes while preserving sinus integrity.
- This approach may reduce the need for more aggressive surgical interventions in children.
Abstract:
Patients with choanal polyp often suffer from maxillary sinusitis of the same side. Hence, Caldwell-Luc operation in addition to polypectomy has been recommended for the treatment of choanal polyp. Choanal polyp occurs more frequently in children with nasal polyp(s) than in adults with nasal polyp(s). For this reason, it is preferable to perform surgery so as to preserve the maxillary sinus as much as possible. The authors surgically treated two children with choanal polyp. A 12-year-old girl had a choanal polyp arising from the posterior portion of the middle turbinate and received an osteoplastic maxillary operation and functional endoscopic sinus surgery (FESS). The other, a 13-year-old girl, with an antro-choanal polyp underwent FESS only. One year after surgery, both patients showed no recurrence of polyp and had recovered an aerated maxillary sinus cavity covered with normal mucous membrane. Based on the experiences of these two cases, FESS appears to be very helpful in treating children with choanal polyp and paranasal sinusitis.