Prolapsed Antral Mucosa: Variant of Maxillary Sinus Mucocele / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: An array of diseases may cause masses in the maxillary sinus. Among the various diseases, the prolapsed antral mucosa (PAM) presents an inflammed, swollen maxillary antral mucosa which becomes redundant and prolapsed into the nasal cavity through a widened natural ostium, mimicking an antrochoanal polyp. The purposes of this study were to introduce prolapsed antral mucosa and evaluate the differences between prolapsed antral mucosa and other diseases, particularly maxillary sinus mucocele. MATERIALS AND METHODS: We retrospectively analyzed 18 patients who were diagnosed with prolapsed antral mucosa at the Kangbuk Samsung Hospital between 1990 and 1998. The presenting signs and symptoms, endoscopic finding, radiological finding, histopathological finding were reviewed. RESULTS: Of the symptoms reported by patients in this study, nasal obstruction was the most frequent, followed by rhinorrhea, postnasal drip, foul odor and headache. Endoscopic findings showed protruding maxitlary antral mucosa into the middle meatus. On the CT, the prolapsed antral mucosa presented features such similar to antrochoanal polyp as unilateral and homogeneous soft tissue density which extended into the middle meatus. MR imaging was useful for differentiating the prolapsed antral mucosa from neoplasms and antrochoanal polyp. Prolapsed antral mucosa and maxilla sinus mucocele showed the same histopathological features such as epithelial lining of columnar or metaplastic squamous cells with varying glandular structures, and dense fibrous stroma intiltrated by infiammatory cells. CONCLUSIONS: The prolapsed antral mucosa is considered as a variant of maxillary sinus mucocele. History, physical examination, biopsy, CT and MM are useful for differentiating the prolapsed antral mucosa from other diseases. Although a prolapsed antral mucosa is rare, it should be considered in the diagnosis and the treatment of unilateral maxillary sinus lesion.

Outcomes of Transnasal Endoscopic Sinus Surgery in 62 Cases of Antrochoanal Polyp

This study was conducted to review the clinical features of antrochoanal polyp and to evaluate the effectiveness of transnasal endoscopic sinus surgery as a primary surgical method in treating antrochoanal polyp. We reviewed the profiles, which included clinical symptoms, past surgical history, surgical techniques and operative findings, of 57 patients (62 cases) treated for antrochoanal polyp with transnasal endoscopic sinus surgery during the past four years. Out of this subject pool, 45 patients (50 cases) underwent follow-up examinations and were analyzed. The follow-up periods ranged from 18 to 63 months and averaged 33 months. About half of the cases involved pediatric-to-young-adult patients (under 20 years) and five cases were bilateral. The most frequent site of origin was the natural ostium of the maxillary sinus, followed by the posteromedial wall and the posterolateral wall. Recurrences after endoscopic sinus surgery were observed in five cases, which were subsequently treated with revision endoscopic sinus surgery. In these cases of recurrence, there was no evidence of recurrence during a mean follow-up period of 30 months. These results suggest that transnasal endoscopic sinus surgery may be appropriate for the primary treatment of antrochoanal polyp and useful in the treatment of recurrent cases, especially those involving children.

A Neurofibroma Arising from the Nasal Septum / 대한이비인후과학회지

Neurofibroma rarely occurs as a solitary lesion but mostly occurs as part of neurofibromatosis and reports of neurofibromas developed in the nasal cavity or paranasal sinus are very rare. We present here a case of neurofibroma in a 57 year-old female who complained of purulent rhinorrhea, nasal obstruction and epiphora, all of which persisted for a year. Anterior rhinoscopic examination showed huge polypoid mass in the right nasal cavity, and CT/MRI revealed an expansive, highly enhancing mass in the right nasal cavity remodeling the right lateral nasal wall, the middle turbinate and the inferior turbinate. The radiologic examinations also showed secretions in the right maxillary and ethmoid sinuses. We removed this tumor completely by transnasal endoscopic surgery. No evidence of recurrence was found by the twelfth month following the operation.