Maxillary Sinus Antrochoanal Polyp Recurrence Following Surgery in Adults: A Systematic Review

Antrochoanal polyps (ACPs) are cystic non-neoplastic lesions that most commonly originate from the maxillary sinus and may extend posteriorly through the choana. Transnasal endoscopic removal is preferred for symptomatic ACPs. ACPs can recur after surgical removal, and while a 15% recurrence rate was published in a systematic review on pediatric ACPs, this has not been well-established in adults. The purpose of this systematic review was to determine the recurrence rate of maxillary sinus ACPs following surgical resection in adults.

A systematic review was conducted on ACP resection using Medline, Embase, and Web of Science databases from 1946 to July 2025.

After excluding duplicate and non-English articles, 395 abstracts were screened, and 63 articles were selected for full-text review. Articles were included if they were original studies that reported recurrence rates after surgical resection of maxillary sinus ACPs in patients ≥ 16 years old. Articles were excluded if study populations had minimum follow-up of less than 6 months or mean follow-up of less than 12 months.

After full-text review, 16 studies met inclusion criteria with 439 patients being utilized for analyses. Mean age was 33.8 years and 39.7% were female. Endoscopic middle meatal antrostomy with ACP removal was performed in 80.8% of cases. Following surgery, patients experienced an overall recurrence rate of 9% (95% CI: 6%-14%), with a mean follow-up of 36.8 months.

ACPs recurred in about 9% of adults following surgical resection. Further research is needed to determine whether certain patient factors and surgical techniques are associated with ACP recurrence.