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[Antrochoanal polyps: diagnosis and management].

Fr Facon1, J Paris, P Dessi

  • 1Fédération d'Oto-Rhino-Laryngologie et de chirurgie de la face et du cou, Centre hospitalier universitaire de la Timone, 264, rue Saint-Pierre 13385 Marseille Cedex 05 France. Frederic.FACON@mail.ap-hm.fr

Annales D'Oto-Laryngologie Et De Chirurgie Cervico Faciale : Bulletin De La Societe D'Oto-Laryngologie Des Hopitaux De Paris
|February 16, 2005
PubMed
Summary

Antrochoanal polyps are benign maxillary sinus tumors in children, often causing nasal obstruction. Endoscopic surgery is the primary treatment, with an external approach reserved for recurrences.

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Area of Science:

  • Otolaryngology
  • Pediatric Surgery
  • Head and Neck Oncology

Background:

  • Antrochoanal polyp is a unilateral, benign maxillary sinus tumor predominantly affecting children.
  • The exact physiopathology of antrochoanal polyps remains unclear.
  • Common presenting symptoms include unilateral nasal obstruction and discharge, though atypical presentations can occur.

Purpose of the Study:

  • To summarize the diagnosis and treatment of antrochoanal polyps in children.
  • To emphasize the role of endoscopic surgery as the primary treatment modality.
  • To outline alternative surgical approaches for recurrent or incompletely resected cases.

Main Methods:

  • Diagnosis relies on radiographic imaging, primarily CT scans, with MRI used less frequently.

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  • Surgical resection is the definitive treatment.
  • Endoscopic endonasal surgery, specifically double maxillary meatotomy, is the preferred first-line approach.

    • Main Results:

    • Endoscopic double maxillary meatotomy provides adequate exposure for complete polyp pedicle resection.
    • Coagulation of the polyp pedicle insertion site is recommended.
    • Recurrence or incomplete resection may necessitate an external approach, such as the Caldwell-Luc procedure.

    Conclusions:

    • Antrochoanal polyps are manageable pediatric maxillary sinus tumors.
    • Endoscopic surgery is effective and recommended for initial treatment.
    • External approaches serve as a valuable alternative for complex or recurrent cases.