ABSTRACT
Antrochoanal polyps are rare lesions. We report a series of 40 consecutive cases of antrochoanal polyps treated in our tertiary centre over a period of ten years between May 1998 and April 2008. The median age of the patients was 37 years. The most common clinical symptom was nasal obstruction (92.5%) followed by rhinorrhoea (45%), postnasal drip (35%) and snoring (22.5 %). The median period of follow-up of these patients was 30 months. Various surgical approaches were used; the commonest was powered endoscopic polypectomy and middle meatal antrostomy in 28 patients (70%), followed by endoscopic polypectomy and middle meatal antrostomy in seven patients (17.5%). Five patients (12.5%) underwent powered endoscopic polypectomy without middle meatal antrostomy. In addition, two patients had septoplasty and one had a frontal sinustomy. There were six patients (15%) who had combined sublabial antrostomy. No major complications occurred; four patients relapsed; three patients had initial operation performed elsewhere and one patient developed recurrence after the first surgery. The median hospitalization period was three days. We conclude that, the use of powered instrumentation in the removal of antrochoanal polyps is safe, effective and associated with minimal morbidity.
ABSTRACT
Congenital Choanal Atresia is a relatively uncommon anomaly. Among various surgical approaches for treating this ailment that have been proposed to date, transpalatal and transnasal endoscopic approaches are the preferred methods for surgical treatments. Because restenosis is the most important post-surgical concern, some authors used topical application of mitomycin C in the choanal atresia and found it to be effective in the prevention and treatment of scar formation. We have experienced a case of right membranous choanal atresia and left membranous choanal stenosis which were treated with a transnasal endoscopic approach using powered instrumentations and topical application of mitomycin C without an application of prolonged stent. Eight months after the treatment, patent neochoanae remains without evidence of restenosis.
Subject(s)
Choanal Atresia , Cicatrix , Constriction, Pathologic , Endoscopes , Mitomycin , StentsABSTRACT
BACKGROUND AND OBJECTIVES: The aims of the current study are to reintroduce a surgical technique for endoscopic removal of the antral portion of antrochoanal polyp (ACP) by powered instrumentation and to determine its efficacy by evaluating the outcome of the patients. MATERIALS AND METHOD: A prospective study was performed in 28 patients undergoing endoscopic sinus surgery for ACP by the author's surgical technique. Improvements of clinical symptoms and endoscopic and computed tomographic findings were evaluated postoperatively with a follow-up period ranging from 12 to 52 months. All symptom scores on a 100 mm visual analog scale before operation were compared with those obtained at the last visit after operation. Postoperative endoscopic and computed tomographic findings were graded using a three-point scale ranging from 0 to 2. In the surgical technique, the antral portion of ACP was identified through the enlarged ostium under intranasal endoscopy and removed by a blade of powered instrumentation that was inserted through the canine fossa. RESULTS: Symptom scores were all significantly reduced postoperatively. All but one patient showed improvement in clinical symptoms and endoscopic and computed tomographic findings during the follow-up period. There were no major complications specific to this technique. CONCLUSION: This technique provides an attractive alternative to other methods for removing the antral portion of ACP and is associated with excellent outcomes and the minimal morbidities rate.