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Sphenochoanal polyps in children - a systematic review (1995‒2021)
Krystian Tywoniuk1, Karolina Haber1, Józef Mierzwiński2
1Children's Hospital of Bydgoszcz, Department of Otolaryngology, Audiology and Phoniatrics, Pediatric Auditory Implant Program. Ul. Chodkiewicza 44, 85-667 Bydgoszcz, Poland.
Insights
Sphenochoanal polyps in children are rare and often misdiagnosed. Endoscopic sphenoidotomy is an effective treatment with no reported recurrences in pediatric patients, highlighting its importance in diagnosis and management.
Area of Science:
- Otolaryngology
- Pediatric Surgery
- Rhinology
Background:
- Sphenochoanal polyps, originating in the sphenoid sinus and extending to the nasopharynx, are uncommon in children.
- Previous reports are limited to case studies, necessitating a comprehensive review of existing literature.
Approach:
- A systematic literature review was conducted using PubMed, MEDLINE, and Cochrane Library databases.
- Studies published before December 2021 reporting on pediatric sphenochoanal polyps were analyzed.
- Data on clinical presentation, diagnosis, management, surgical techniques, and recurrence rates were extracted.
Key Points:
- Eleven pediatric cases (ages 3.5-16 years) were identified across nine articles.
- Common symptoms include nasal obstruction, discharge, and headache.
- All patients underwent surgical treatment, with endoscopic sphenoidotomy showing no recurrences.
Conclusions:
- Sphenochoanal polyps require consideration in the differential diagnosis of unilateral sinonasal masses in children.
- Misdiagnosis, particularly with antrochoanal polyps, can lead to inadequate treatment and recurrence.
- Nonspecific symptoms underscore the need for accurate diagnosis and appropriate surgical intervention, including sphenoidotomy.
Objectives:
Nasal polyps that originate from the sphenoid sinus and reach the nasopharynx are called sphenochoanal polyps. Reports on sphenochoanal polyps in children have thus far been limited only to case reports. This review aims to describe and summarize clinical presentation, diagnosis, management, surgical approaches to the sphenochoanal polyps with recurrence rate after surgery in pediatric patients reported in the literature.
Methods:
A systematic literature review was performed using PubMed, MEDLINE and Cochrane Library Databases for articles published prior to December 2021 to identify all studies reporting on pediatric patients with sphenochoanal polyps. Clinical presentation, management options, surgical approaches and outcomes of applied management were extracted from included studies.
Results:
9 articles provided data on 11 eligible patients with an age range 3 years and 8 months-16 years. The commonest symptoms included: nasal obstruction, nasal discharge, and headache respectively. All patients were subjected to surgical treatment. No recurrences after the endoscopic sphenoidotomy were reported.
Conclusion:
Sphenochoanal polyps should be kept in mind in the differential diagnosis of unilateral nasal cavity or paranasal sinuses masses. Misdiagnosis can result in recurrences in patients with sphenochoanal polyp, who can be mistakenly diagnosed with antrochoanal polyp and underwent inadequate treatment not involving sphenoidotomy and exact identification of the site of implantation. The symptoms of sphenochoanal polyps are nonspecific.
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