Endoscopic management of paediatric antrochoanal polyp: our experience

Antrochoanal polyp is a benign polypoid lesion arising from the oedematous mucosa of the maxillary sinus and extending through the maxillary ostium into the nose. In children, it constitutes 33% of all nasal polyps. Surgery is the usual treatment for antrochoanal polyps. The primary aim of treatment for antrochoanal polyp is complete removal with total clearance of the maxillary sinus. Herein, we present 36 cases of children with antrochoanal polyps (ACPs). All patients underwent preoperative radiological assessment by CT scan. All patients were subjected to uncinectomy and modified type III maxillary sinusotomy of the maxillary ostium for removal of the ACPs. Modified type III maxillary sinusotomy was performed by dilatation of the ostium of the maxillary sinus posteriorly, inferiorly and anteriorly. The most frequent presenting complaint was unilateral nasal obstruction, followed by rhinorrhoea. In 28 children, the polyps passed through the main ostium, while in 5 patients the polyp passed through the accessory ostium. In 3 children, the origin could not assessed. The antral portion of the ACP was cystic in 3 patients and polypoidal in 33 cases. Recurrence was reported in 4 patients (11.1%) that were subjected to revision endoscopic sinus surgery. The follow-up period ranged from 12 months to 5 years with a mean of 3.5 years.