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Endoscopic sinus surgery for antrochoanal polyps in children
1Department of Otolaryngology, Chang Gung Memorial Hospital, Chang Gung University, Taipei, Taiwan. entlee@adm.cgmh.org.tw
Insights
Endoscopic surgery effectively treats antrochoanal polyps (ACPs) in children. The combined endoscopic and transcanine approach showed a 100% success rate, offering a safe and effective treatment option for pediatric patients.
Area of Science:
- Otolaryngology
- Pediatric Surgery
- Endoscopic Sinus Surgery
Background:
- Antrochoanal polyps (ACPs) are common in children and young adults.
- Endoscopic surgery is a recognized treatment for adult ACPs, but pediatric data is limited.
Purpose of the Study:
- To evaluate the outcomes of endoscopic surgical treatment for antrochoanal polyps in pediatric patients.
Main Methods:
- A prospective study of 26 children from January 1998 to February 2004.
- Utilized transnasal endoscopic (TE) and combined endoscopic and transcanine (CET) approaches for complete polyp base removal.
- CET approach specifically for polyps originating from the maxillary sinus lateral wall.
- Post-operative CT scans at 1 year assessed surgical outcomes.
Main Results:
- ACPs frequently originated from the posterior (92.3%), lateral (61.5%), and inferior (38.5%) walls of the maxillary sinus.
- The TE approach achieved a 76.9% success rate, while the CET approach had a 100% success rate.
- Recurrences in the TE group (3 patients) were associated with rhinosinusitis and successfully treated with revision CET surgery.
- No significant complications were reported.
Conclusions:
- Endoscopic treatment for pediatric ACPs is safe and effective.
- Early diagnosis and intervention are crucial to prevent complications like secondary rhinosinusitis, which can complicate surgery.
Objective:
The antrochoanal polyp (ACP) occurs predominantly in children and young adults. Endoscopic surgery is effective for the treatment of ACPs in adults; however, articles discussing the treatment in pediatric patients are rare. The purpose of this study was to evaluate the outcome of endoscopic treatment of ACPs in children.
Study Design And Setting:
Between January 1998 and February 2004, 26 children were prospectively enrolled in this study. Completely removing the base of the ACPs was achieved through transnasal endoscopic (TE) or combined endoscopic and transcanine (CET) approach. The CET approach was used in ACPs originated from the lateral wall of antrum. All patients received CT scan 1 year after surgery to evaluate the outcome of surgery.
Results:
Most of the ACPs were multitudinous and the distributions of the ACPs' origin in the maxillary sinus were as follows: posterior wall (92.3%), lateral wall (61.5%), and inferior wall (38.5). The success rate was 76.9% in the TE approach and 100% in the CET approach. Three in the TE approach recurred and all of them had concomitant rhinosinusitis. All three patients were cured in the revision CET operations. No major complications occurred.
Conclusion:
Endoscopic treatment of ACPs in children is safe and effective. Early diagnosis and treatment of ACPs is important because secondary rhinosinusitis can make the disease complicated and the surgeries difficult.
