RESUMEN
OBJECTIVES: To introduce a new surgical technique for endoscopic removal of the antral portion of antrochoanal polyp (ACP) by powered instrumentation and to determine its efficacy by measures of relevant patient outcome. STUDY DESIGN: Prospective study in 28 patients undergoing endoscopic sinus surgery for ACP by our surgical technique. METHODS: 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 analogue scale before operation were compared with those 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 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: Our technique provides an attractive alternative to other methods for removing the antral portion of an ACP and is associated with excellent outcomes and minimal morbidities.
Asunto(s)
Endoscopía , Neoplasias del Seno Maxilar/cirugía , Pólipos Nasales/cirugía , Pólipos/cirugía , Adolescente , Adulto , Niño , Femenino , Humanos , Masculino , Neoplasias del Seno Maxilar/diagnóstico , Neoplasias del Seno Maxilar/patología , Persona de Mediana Edad , Pólipos Nasales/diagnóstico , Pólipos Nasales/patología , Pólipos/diagnóstico , Pólipos/patología , Complicaciones Posoperatorias/diagnóstico , Estudios Prospectivos , Instrumentos Quirúrgicos , Tomografía Computarizada por Rayos XRESUMEN
We treated 24 cases of orbital pseudotumour from January 1981 through January 1993. The clinical characteristics and treatment outcomes were analyzed retrospectively by reviewing the medical records, radiological studies, and histological examination. All patients presented with symptoms related to the eye (proptosis, lid swelling, limited ocular motion and/or pain, chemosis, and visual disturbance), while only five patients had symptoms pertaining to the ear, nose, and throat besides the ophthalmological symptoms. Plain X-ray findings were not contributory to the diagnosis. Computed tomograms (CT) showed non-specific findings such as hypertrophy of the extra-ocular muscles and well-defined or poorly defined mass. Pathological findings were non-specific, only to reveal benign lymphoid hyperplasia and inflammatory cell infiltration with necrotizing vasculitis. Twenty-four patients were treated with high-dose steroid therapy which resulted in a significant improvement in 10 patients (42%).
