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Recurrences of surgery for antrochoanal polyps in children: A systematic review

Francesca Galluzzi1, Lorenzo Pignataro2, Marcello Maddalone3

  • 1Department of Otorhinolaryngology, San Gerardo Hospital, Monza, Italy.

International Journal of Pediatric Otorhinolaryngology
|February 16, 2018
PubMed

Insights

Recurrence rates for antrochoanal polyps (ACPs) in children remain high. A combined surgical approach may reduce recurrence compared to other methods, though risk factors require further study.

Area of Science:

  • Otolaryngology
  • Pediatric Surgery
  • Surgical Outcomes

Background:

  • Antrochoanal polyps (ACPs) are benign growths in the maxillary sinus.
  • Recurrence after surgical removal of ACPs in children is a significant clinical concern.
  • Understanding recurrence rates and risk factors is crucial for optimizing pediatric surgical management.

Purpose of the Study:

  • To evaluate the recurrence rate of antrochoanal polyps (ACPs) following surgical intervention in pediatric patients.
  • To compare recurrence rates across different surgical techniques for ACPs.
  • To identify potential risk factors associated with ACP recurrence in children.

Main Methods:

  • Systematic review of English-language studies published from June 1989 to October 2017.
  • Searched PubMed and MEDLINE databases for studies on the surgical treatment of ACPs in children.
  • Included thirteen studies (eight retrospective, five prospective) involving 285 participants.

Main Results:

  • The overall mean recurrence rate after ACP surgery was 15.0%.
  • The combined approach (FESS with transcanine sinusoscopy/mini Caldwell-Luc) showed a significantly lower recurrence rate (0%) compared to FESS (17.7%) or simple polypectomy (50%).
  • No significant difference in recurrence was observed between the combined approach and Caldwell-Luc surgery; risk factor analysis was inconclusive.

Conclusions:

  • Antrochoanal polyp recurrence in children remains a challenge.
  • Functional endoscopic sinus surgery (FESS) is a primary treatment, with external approaches considered for recurrent cases.
  • A combined surgical approach may decrease recurrence rates in select pediatric patients unsuitable for purely endoscopic management.
Abstract

Keywords:
Antrochoanal polypsChildrenRecurrenceSurgery

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