scholarly journals The role of functional sinus surgery for treatment of antrochoanal polyp

2007 ◽  
Vol 54 (2) ◽  
pp. 69-73
Author(s):  
I. Pendjer ◽  
Z. Dudvarski ◽  
Lj. Janosevic ◽  
A. Mikic ◽  
Z. Vujicic
Keyword(s):  
Maxillary Sinus ◽  
Benign Lesion ◽  
Maxillofacial Surgery ◽  
Pathological Process ◽  
Sinus Surgery ◽  
Antrochoanal Polyp ◽  
Ct Findings ◽  
Canine Fossa ◽  
Clinical Center ◽  
Minimal Damage

Antrochoanal polyp (ACP) is a benign lesion which arises from the mucosa of maxillary sinus, fills it and expands through natural ostium towards choana protruding in the epipharynx. Objective: to present our experience in endoscopic surgery of ACP. Material and methods: prospective study included 24 patients operated at the Institute of Otorinolaryngology and Maxillofacial surgery, Clinical Center of Serbia, Belgrade, in the period 2002- 2004. Subjective symptoms, endoscopic and CT findings were evaluated postoperatively, following up the patients in the period 12-20 months. Subjective difficulties of patients were tested by 100mm-analogue scale, while endoscopic and CT findings were demonstrated by three-stage scale from 0 to 2. Applying the technique of ACP extraction in Trendelenburg?s position and approaching the part which protrudes in the epipharynx, we successfully removed the endonasal part by means of curved forceps for epipharyngeal biopsy. By endoscopic middle meatotomy, the natural ostium of maxillary sinus was expanded and pathological process from the very sinus was successfully removed. Results: only one female patient had the majority of symptoms after the operation, while all others had no complaints. Endoscopic and CT findings were normal in all patients at the latest control, without any signs of ACP recurrence. There were no intraoperative or postoperative complications. Conclusion: minimal damage to sinus mucosa due to forceps is lesser problem than complications developed upon creating even the miniature opening in the canine fossa. Using this technique, a dexterous surgeon may successfully extract pathological process with minimal incidence of recurrence, and, more important, with no complications and maximally fast recovery of patients. .

scholarly journals Computed tomography findings after endoscopic sinus surgery with preserving or enlarging maxillary sinus ostium surgery

2011 ◽  
Vol 49 (4) ◽  
pp. 438-444
Author(s):  
J. Myller ◽  
P. Dastidar ◽  
T. Torkkeli ◽  
M. Rautiainen ◽  
S. Toppila-Salmi
Keyword(s):  
Computed Tomography ◽  
Maxillary Sinus ◽  
Endoscopic Sinus Surgery ◽  
Symptom Relief ◽  
Sinus Surgery ◽  
Ct Scans ◽  
Ct Findings ◽  
Middle Meatal Antrostomy ◽  
Sinus Ostium ◽  
Subjective Outcomes

Endoscopic sinus surgery (ESS) is the main surgical approach in the treatment of chronic rhinosinusitis (CRS) after failure of medical treatment. ESS is based on the theory that obstruction of the maxillary sinus ostium is mainly behind the pathogenesis of CRS. Controversy remains concerning the enlargement of the natural maxillary sinus ostium. The aim of this study was to compare computed tomography (CT) findings after preservation or enlargement of the maxillary sinus ostium. Thirty patients with non-polypous CRS underwent randomized endoscopic sinus surgery with uncinectomy on one side and additional middle meatal antrostomy on the other side. Lund-Mackay (LM) scores and the ostium diameters were analysed from CT scans taken preoperatively and nine months postoperatively, and were used for comparison of the two operative techniques. In addition, the correlation between CT findings and subjective outcomes was studied. Comparison of the preoperative and postoperative CT scans revealed that significant reduction of LM score was achieved on both sides, regardless of the type of procedure performed. The postoperative area of the ostium remained significantly larger on the antrostomy side compared to the uncinectomy side. A large maxillary sinus ostium size seems to associate with lower postoperative LM score, but does not seem to provide superior symptom relief.

The Incidence of Complications after Canine Fossa Puncture Performed during Endoscopic Sinus Surgery

2005 ◽  
Vol 19 (2) ◽  
pp. 203-206 ◽  
Author(s):  
Simon R. Robinson ◽  
Robert Baird ◽  
Tong Le ◽  
Peter John Wormald
Keyword(s):  
Maxillary Sinus ◽  
Facial Pain ◽  
Complete Removal ◽  
Sinus Surgery ◽  
Canine Fossa ◽  
Number Of Patients ◽  
Facial Numbness ◽  
Cheek Swelling ◽  
Made In

Background Patients with extensive disease affecting the maxillary sinus may require a canine fossa approach for complete removal of disease. This study was designed to determine the complications associated with this procedure. Methods We performed a retrospective study of 21 patients who had undergone a canine fossa puncture at an academic hospital complex in Adelaide, Australia. Results A total of 37 canine fossa punctures were made in 21 patients. Twenty-eight of the 37 (75.7%) sides in which a canine fossa puncture was performed experienced a complication. The most common complaint was of cheek swelling in 14 (38%) followed by facial pain in 12 (32%), facial numbness in 11 (30%), cheek pain in 10 (27%), dental numbness in 10 (27%), gingival complications in 9 (24%), and facial tingling in 6 (16%) of sides. Most complications (75.5%) resolved within the 1st month after surgery. Six patients (28.6%) had persistent complications with facial tingling in 3 patients (50%) followed by facial numbness and tingling in 1 patient (11%), facial numbness alone in 1 patient (8.3%), and facial pain in 1 patient (7.1%). Conclusion Canine fossa antrostomy is a technique that provides additional access to the maxillary sinus. Surgeons need to be aware that, although minor, a significant number of patients will experience both transient and long-term complications.

scholarly journals Antrochoanal polyp mimicking juvenile nasoangiofibroma

2013 ◽  
Vol 12 (4) ◽  
pp. 432-434
Author(s):  
NA Muhammed ◽  
I Mohamad ◽  
B Abdullah
Keyword(s):  
Sleep Disturbance ◽  
Maxillary Sinus ◽  
Nasal Obstruction ◽  
Benign Lesion ◽  
Medical Science ◽  
Antrochoanal Polyp ◽  
Nasal Mass ◽  
Postnasal Drip

Antrochoanal polyp is a benign lesion, usually arising from the maxillary sinus extending posteriorly into the nasopharynx. Typically it presents as a unilateral nasal obstruction with mucopus rhinorrhea, sleep disturbance, postnasal drip, and mouth breathers. Epistaxis is an extremely rare complaint. Unilateral nasal mass presenting in a teenage boy will increase the suspicion of juvenile nasoangiofibroma. We report a teenage with extensive unilateral nasal mass with such presentation, which later turned out to be antrochoanal polyp. DOI: http://dx.doi.org/10.3329/bjms.v12i4.16664 Bangladesh Journal of Medical Science Vol. 12 No. 04 October ’13 Page 432-434

Is the Canine Fossa Puncture Approach Really Necessary for the Severely Diseased Maxillary Sinus during Endoscopic Sinus Surgery?

2008 ◽  
Vol 118 (6) ◽  
pp. 1082-1087 ◽  
Author(s):  
Jae Yong Lee ◽  
Sang Hag Lee ◽  
Hyun Sook Hong ◽  
Jong Dae Lee ◽  
Sung Hoon Cho
Keyword(s):  
Maxillary Sinus ◽  
Endoscopic Sinus Surgery ◽  
Sinus Surgery ◽  
Canine Fossa

scholarly journals Bilateral antrochoanal polyp: case report, literature review and clinical guidelines

New Medicine ◽  
2018 ◽  
Vol 22 (4) ◽  
Author(s):  
Agata Wasilewska ◽  
Lidia Zawadzka-Głos
Keyword(s):  
Maxillary Sinus ◽  
Complete Removal ◽  
Paediatric Population ◽  
Sinus Surgery ◽  
Antrochoanal Polyp ◽  
Benign Lesions ◽  
Endoscopic Control ◽  
High Incidence ◽  
Sinus Ostium

Antrochoanal polyps are unilateral benign lesions that arise within the maxillary sinus antrum. The purpose of this study was to review the clinical characteristics and treatment of antrochoanal polyp (ACP). A retrospective analysis was performed to investigate the case of one patient with an extremely rare bilateral polyp with a high incidence of recurrence. ACPs account for approximately one-third of polyps occurring in children. Most of them are unilateral. The recurrent course of ACP is more prevalent in the paediatric population than in adults. ACPs require differential diagnosis with malignancies. The mainstay of treatment is surgery. The gold standard is endoscopic sinus surgery with complete removal of polyp mass under endoscopic control and widening of the maxillary sinus ostium via the middle meatus. Postoperative follow-up of at least 2 years is very important to monitor patients for recurrence.

Changes in the Maxillary Sinus Volume and the Surgical Outcome after the Canine Fossa Puncture Approach in Pediatric Patients with an Antrochoanal Polyp: Results of a Minimum 3-Year Follow-Up

2009 ◽  
Vol 23 (5) ◽  
pp. 531-534 ◽  
Author(s):  
Jae Yong Lee ◽  
Byoung Joon Baek ◽  
Dong Wook Kim ◽  
Jang Yul Byun ◽  
Seung Won Lee ◽  
...  
Keyword(s):  
Maxillary Sinus ◽  
Surgical Outcome ◽  
Pediatric Patients ◽  
Maxillary Antrum ◽  
Antrochoanal Polyp ◽  
Long Term Effects ◽  
Recurrence Rates ◽  
Maxillary Sinus Volume ◽  
Canine Fossa

Background An antrochoanal polyp (ACP) originates from the maxillary antrum and simple excision results in high recurrence rates. Canine fossa puncture (CFP) has been proposed as an alternative method of accessing the entire maxillary antrum. To investigate the long-term effects of the CFP approach on changes in the maxillary sinus volume in pediatric patients with an ACP, we compared the sinus volume on the operated and normal sides, using preoperative computed tomography (CT), and postoperative CT performed at least 3 years after the procedure. The surgical outcomes were also assessed using endoscopic and CT findings. Methods Seven patients met the inclusion criteria and the ACP was removed via the CFP approach. After a mean follow-up period of 43.9 months, we compared the changes in the maxillary sinus volume between the operated and normal sides, using the pre- and postoperative CT data. Results No contractures or decrease in the maxillary sinus volume on the diseased side were observed in any of the patients on postoperative CT, and the average volume of both maxillary sinuses was greater on postoperative CT compared with the preoperative scans. None of the patients showed evidence of recurrence on the endoscopic and CT examinations. Conclusion CFP did not affect the maxillary sinus volume in pediatric patients with an ACP and led to a successful surgical outcome in all of the patients. Based on these results, we recommend CFP as a safe, effective method for the treatment of ACP.

scholarly journals Actinomycosis of antrochoanal polyp: a rare entity

2018 ◽  
Vol 5 (1) ◽  
pp. 215
Author(s):  
Shashikant A. Pol ◽  
Arjun Dass ◽  
Nitin Gupta ◽  
Aditi Mahajan
Keyword(s):  
Maxillary Sinus ◽  
Nasal Obstruction ◽  
Secondary Infection ◽  
Benign Lesion ◽  
Nasal Discharge ◽  
Antrochoanal Polyp ◽  
Rare Entity ◽  
Case Patient ◽  
Complete Excision ◽  
First Case

<p class="abstract">Antrochoanal polyp is a benign lesion, originating from the mucosa of the maxillary sinus, grow into maxillary sinus, nasal cavity and posteriorly to involve the choana. Nasal obstruction and nasal discharge are their main symptoms. Epistaxis is rare as seen in infected cases. Clinical assessment along with radiology helps in the diagnosis of antrochoanal polyp. We hereby describe a case of infected antrochoanal polyp in a 20-year-old female who presented with unilateral nasal obstruction, nasal discharge and intermittent epistaxis. Complete excision was done through endoscopic approach. On histopathology it showed secondary infection caused by actinomycosis which is extremely rare finding. This might be the first case report of actinomycosis infection in antrochoanal polyp as it was not found previously in any antrochoanal polyp case. Patient was followed till 6 month without any symptom.</p>

scholarly journals Antrochoanal Polyp: Updated Clinical Approach, Histology Characteristics, Diagnosis and Treatment

2021 ◽  
Author(s):  
Warman Meir ◽  
Rona Bourla ◽  
Monica Huszar ◽  
Elchanan Zloczower
Keyword(s):  
Maxillary Sinus ◽  
Nasal Polyps ◽  
Squamous Metaplasia ◽  
Complete Removal ◽  
Cyst Formation ◽  
Endoscopic Examination ◽  
Sinus Surgery ◽  
Antrochoanal Polyp ◽  
Inflammatory Reactions ◽  
Male Predominance

Antrochoanal polyp (ACP) is a benign unilateral polyp, originating from the maxillary sinus and expanding through the accessory or natural ostia into the nasal cavity and choanae. It has a 2: 1 male predominance and is more common in children and young adults. The exact pathophysiology is unclear, and it is thought to have less of the inflammatory reactions as opposed to typical bilateral nasal polyps which are commonly seen in diffused chronic rhinosinusitis. The presenting symptoms of ACP are unilateral nasal obstruction and rhinitis. Epistaxis, pain, and foul-smelling secretions are not typically seen and point towards a different etiology. Diagnosis is mainly clinical via endoscopic examination and supported by Computed tomography (CT) imaging. In CT images the three components of the polyp can be identified; an intramaxillary portion, intranasal and choanal components. Treatment is surgical, where Endoscopic sinus surgery (ESS) is the main technique used with other assisting approaches to reach the more challenging anterior and inferior areas of the maxillary sinus. Successful resection depends on complete removal of the intramaxillary component of the polyp to avoid polyp regrowth. The typical histologic characteristics are cyst formation, fibrosis and squamous metaplasia that are significantly more common in ACP than diffused nasal polyps.

Dental and Allergic Aspects of Sinusitis and Nasal Polyposis: A Review

1982 ◽  
Vol 90 (5) ◽  
pp. 527-533 ◽  
Author(s):  
David N.F. Fairbanks
Keyword(s):  
Maxillary Sinus ◽  
Nasal Polyposis ◽  
Combined Therapy ◽  
Third Molar ◽  
Sinus Surgery ◽  
Antrochoanal Polyp ◽  
Dental Origin ◽  
Molar Teeth ◽  
Maxillary Sinus Floor ◽  
Sinus Floor

The proximity of the maxillary sinus floor to the first, second, and third molar teeth predisposes it to contiguous dental disease. Infections of dental origin are usually mixed bacterial growth with anaerobic species predominating; extended-spectrum penicillins or cephalosporins are recommended. The patient with atopic allergy is susceptible to bacterial infection; combined therapy with antimicrobials, corticosteroids, and antihistamines is advised. The large solitary antrochoanal polyp is successfully managed with maxillary sinus surgery alone. Multiple ethmoidal polyps in children suggest cystic fibrosis, and in adults, the asthma triad syndrome. Thorough surgical management of the sinuses combined with antimicrobial and topical corticosteroid therapy is recommended.

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