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Combined approach for paediatric recurrent antrochoanal polyp: a single-centre case series of 27 children

E Mantilla1, P Villamor1, C De La Torre1

  • 1Department of Paediatric Otolaryngology, Hospital Infantil de México Federico Gómez, Mexico City, Mexico.

The Journal of Laryngology and Otology
|May 10, 2019
PubMed

Insights

For pediatric antrochoanal polyps, a combined approach of functional endoscopic sinus surgery and the Caldwell-Luc procedure significantly reduces recurrence compared to surgery alone. This combined method is safe and effective for complete polyp removal.

Area of Science:

  • Otolaryngology
  • Pediatric Surgery
  • Rhinology

Background:

  • Antrochoanal polyps are benign tumors originating from the maxillary sinus.
  • Recurrence of antrochoanal polyps can occur, necessitating further treatment.
  • Functional endoscopic sinus surgery (FESS) is a common treatment, but recurrence rates can be high.

Purpose of the Study:

  • To compare the efficacy and safety of FESS versus a combined approach (FESS + Caldwell-Luc procedure) for treating pediatric antrochoanal polyps.
  • To evaluate recurrence rates and complications associated with each surgical technique.

Main Methods:

  • Retrospective case series of 27 pediatric patients with recurrent antrochoanal polyps.
  • Data collected from January 2010 to January 2018.
  • Comparison of recurrence rates and safety outcomes between FESS alone and FESS + Caldwell-Luc procedure.

Main Results:

  • The recurrence rate for FESS alone was 72.9%, significantly higher than the 12.5% recurrence rate for the combined FESS + Caldwell-Luc procedure (p < 0.00001).
  • Average patient age at diagnosis was 10.4 ± 2.49 years.
  • No surgical or follow-up complications were reported for either group.

Conclusions:

  • Adequate maxillary sinus ventilation and precise polyp origin identification are crucial for preventing recurrence.
  • While FESS is the standard, the combined FESS + Caldwell-Luc procedure offers a superior approach for complete antrochoanal polyp removal, especially in revision cases.
  • The combined approach demonstrates a significantly lower recurrence rate and maintains a favorable safety profile in pediatric patients.
Abstract

Keywords:
Caldwell-LucChildrenFunctional Endoscopic Sinus SurgeryRecurrenceRecurrent Antrochoanal PolypRevision Surgery

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