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 Oncological and quality of life outcomes following extralevator versus standard abdominoperineal excision for rectal cancer

2017 ◽  
Vol 99 (5) ◽  
pp. 402-409 ◽  
Author(s):  
D Kamali ◽  
A Sharpe ◽  
A Musbahi ◽  
A Reddy
Keyword(s):  
Quality Of Life ◽  
Rectal Cancer ◽  
Abdominoperineal Excision ◽  
Long Term Effects ◽  
Recurrence Rates ◽  
Oncological Outcomes ◽  
Significant Difference

INTRODUCTION There is increasing and conflicting research debating the oncological benefits of extralevator abdominoperineal excision (ELAPE) compared with standard abdominoperineal excision (SAPE). However, there is very little in the literature on the long-term effects on patients’ wellbeing following the two procedures. The aim of this study was to determine the oncological outcomes and long-term quality of life (QoL) of patients at two hospitals having undergone ELAPE or SAPE. METHODS Consecutive patients with rectal cancer who underwent either ELAPE or SAPE between January 2009 and June 2015 at a single centre were analysed. Oncological outcomes were determined by histology and follow-up imaging. QoL data were obtained prospectively using the QLQ-C30 and QLQ-CR29 questionnaires. RESULTS A total of 48 patients (36 male, 12 female; 27 ELAPE, 21 SAPE) were reviewed. The mean age was 67.4 years and the median follow-up duration was 44 months (range: 6–79 months). Four patients (2 ELAPE, 2 SAPE) developed local recurrence. Rates of distant metastasis were similar (ELAPE: 11%, SAPE: 14%). There was no significant difference in mean global health status score (ELAPE: 77.3, SAPE: 65.3). Impotence was the most frequently reported problem (mean symptom scores of 89.7 and 78.8 for ELAPE and SAPE respectively). CONCLUSIONS This is the largest study with the longest follow-up period that compares QoL after ELAPE with that after SAPE. Although more radical in nature, ELAPE did not demonstrate any significant impact on QoL compared with SAPE. There was no significant difference in long-term oncological outcome between the groups. Impotence remains a significant problem for all patients and they should be well informed of this risk prior to surgery.

scholarly journals Early Onset Epilepsy Caused by Low-Grade Epilepsy-Associated Tumors and Focal Meningeal Involvement

2020 ◽  
Vol 10 (10) ◽  
pp. 752
Author(s):  
Luca De Palma ◽  
Chiara Pepi ◽  
Alessandro De Benedictis ◽  
Nicola Pietrafusa ◽  
Angela Mastronuzzi ◽  
...  
Keyword(s):  
Surgical Outcome ◽  
Early Onset ◽  
Pediatric Patients ◽  
Seizure Outcome ◽  
Low Grade ◽  
Post Surgery ◽  
Meningeal Involvement ◽  
Patients With Epilepsy ◽  
Associated Tumors

Background: Low-grade epilepsy-associated neuroepithelial tumors (LEATs) are a frequent etiology in pediatric patients with epilepsy undergoing surgery. Objective: To identify differences in clinical and post-surgical follow-up between patients with focal meningeal involvement (MI) and those without MI within our cohort of pediatric patients with LEATs. Methods: We retrospectively reviewed all pediatric patients (<18 y) who underwent epilepsy surgery between 2011 and 2017 at our hospital. Cohort inclusion required histological diagnosis of LEATs and post-surgical follow-up of ≥2 y. We subsequently stratified patients according to presence of neuroradiological MI. Results: We identified 37 patients: five with MI and 32 without. Half of patients (19) were drug sensitive at surgery; similar between groups. The group with MI differed mainly for age of epilepsy-onset (0.6 vs. 7.0 y) but not for epilepsy duration (0.9 vs. 1.5 y). Post-surgery radiological follow-up (median 4.0 y; IQR 2.8–5.0 y) did not indicate disease progression. Seizure outcome was excellent in both groups, with 34 patients overall being both drug- and seizure-free. Conclusions: Our study identified a new subgroup of LEATs with focal MI and excellent post-surgical outcome. Moreover, this highlights the effectiveness of early surgery in pediatric LEATs.

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.

scholarly journals LINC-01. COMPLIANCE TO FOLLOW UP IN PEDIATRIC PATIENTS WHO HAVE RECEIVED CRANIOSPINAL IRRADIATION

2020 ◽  
Vol 22 (Supplement_3) ◽  
pp. iii378-iii378
Author(s):  
Khin Pyone ◽  
Thwe Tun ◽  
Yin Win ◽  
Aye Thinn ◽  
Khin Win ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Pediatric Cancer ◽  
Pediatric Patients ◽  
Tertiary Hospital ◽  
Craniospinal Irradiation ◽  
Long Term Effects ◽  
Pediatric Cancer Patients ◽  
Need To Evaluate

Abstract OBJECTIVE Attendance to follow-up after completion of cancer treatment is understudied area. Pediatric cancer patients have sequelae of illness or treatment. Many have no symptom immediately after completion of treatment. Long term follow-up is important to access disease control, early diagnosis of recurrence, second cancer and treatment-related morbidities. Purpose of this study was to evaluate the compliance to follow-up in pediatric patients treated with craniospinal irradiation (CSI). METHODS This was retrospective review of follow-up in pediatric neuro-oncology patients who received (CSI) from January 2017 to June 2018 in the Radiotherapy Department of Yangon General Hospital, Myanmar. RESULT: Twenty-three patients received CSI; majority (43%) were medulloblastoma. Median age was 7.5 years (3–17 years). Only seven patients (30.4%) were attended to follow-up more than 6 months after completion of treatment. More than two-thirds of patients (n=16,69.6%) were lost to follow-up. Patients in active follow-up were diagnosed and treated at earlier age below 10years (n=5,21.7%). Demographically, 5 patients (22%) were living in the region around tertiary hospital. Sixteen patients (69.6%) from rural area had limited transportation and difficulty for accommodation in which they were treated. In socioeconomic points, 18 parents (78.2%) had poor education and financial status, lack of understanding about disease, treatment, long-term effects and follow-up. CONCLUSION Although this was limited data in CSI patients only, loss to follow-up after 6 months was high. We need to evaluate in all pediatric cancer patients and collaborate to provide financial support, childcare centres for lodging, transportation and health education to promote compliance to follow-up.

scholarly journals Bimodal intervention in cystic lesions of the maxillary antrum

2020 ◽  
Vol 6 (12) ◽  
pp. 2320
Author(s):  
Manish Munjal ◽  
Venus Tilavat ◽  
Porshia Rishi ◽  
Shubham Munjal ◽  
Harjinder Sidhu ◽  
...  
Keyword(s):  
Maxillary Sinus ◽  
Maxillary Antrum ◽  
Surgical Excision ◽  
Cystic Lesions ◽  
Middle Meatus ◽  
Complete Surgical Excision ◽  
Canine Fossa ◽  
Close Proximity

<p class="abstract">Intrinsic or extrinsic cysts are common maxillary antral lesions as there is close proximity between the maxillary antrum and maxillary teeth. Main stay of treatment is complete surgical excision. Endoscopic trans nasal middle meatus corridor and the canine fossa approach facilitate 360-degree access, resection and removal of cystic lesions of the maxillary antrum. Bimodal technique to treat maxillary cysts that have expanded into the maxillary sinus is discussed here.  </p>

The effect of anatomic variations and maxillary sinus volume in antrochoanal polyp formation

2019 ◽  
Vol 277 (4) ◽  
pp. 1067-1072
Author(s):  
Engin Başer ◽  
Orkun Sarıoğlu ◽  
İlker Burak Arslan ◽  
İbrahim Çukurova
Keyword(s):  
Maxillary Sinus ◽  
Antrochoanal Polyp ◽  
Anatomic Variations ◽  
Polyp Formation ◽  
Maxillary Sinus Volume

Endoscopic Surgical Approach for Antrochoanal Polyps

1991 ◽  
Vol 5 (6) ◽  
pp. 211-214 ◽  
Author(s):  
Sujana S. Chandrasekhar ◽  
Joseph B. Jacobs
Keyword(s):  
Surgical Technique ◽  
Maxillary Sinus ◽  
Surgical Approach ◽  
Antrochoanal Polyp ◽  
Minimal Morbidity ◽  
Sinus Mucosa

The endoscopic surgical technique for the removal of antrochoanal polyps is a safe and effective method with minimal morbidity. We present our results in 14 patients treated with this approach. The follow-up time ranged from 3 months to 3 years with an average of 2 years. All patients are symptom free with normal appearing maxillary sinus mucosa on office endoscopy. Only two patients required a Caldwell-Luc procedure. There were no complications in our series. We recommended the endoscopic surgical technique for the management of the antrochoanal polyp.

Branchial Anomalies in the Pediatric Population

2007 ◽  
Vol 137 (2) ◽  
pp. 289-295 ◽  
Author(s):  
James W. Schroeder ◽  
Nadia Mohyuddin ◽  
John Maddalozzo
Keyword(s):  
Retrospective Study ◽  
Surgical Treatment ◽  
Pediatric Patients ◽  
Pediatric Population ◽  
Tertiary Care ◽  
Epithelial Lining ◽  
Pediatric Hospital ◽  
Recurrence Rates ◽  
Branchial Anomalies

OBJECTIVE: We sought to review the presentation, evaluation, and treatment of branchial anomalies in the pediatric population and to relate these findings to recurrences and complications. STUDY DESIGN AND SETTING: We conducted a retrospective study at a tertiary care pediatric hospital. PATIENTS: Ninety-seven pediatric patients who were treated for branchial anomalies over a 10-year period were reviewed. Patients were studied if they underwent surgical treatment for the branchial anomaly and had 1 year of postoperative follow-up; 67 children met criteria, and 74 anomalies were studied. RESULTS: Patients with cysts presented at a later age than did those with branchial anomaly fistulas or sinus branchial anomalies. 32% of branchial anomalies were previously infected. Of these, 71% had more than one preoperative infection. 18% of the BA were first arch derivatives, 69% were second arch derivatives and 7% were third arch derivatives. There were 22 branchial cysts, 31 branchial sinusies and 16 branchial fistulas. The preoperative and postoperative diagnoses differed in 17 cases. None of the excised specimens that contained a cystic lining recurred; all five recurrences had multiple preoperative infections. CONCLUSIONS: Recurrence rates are increased when there are multiple preoperative infections and when there is no epithelial lining identified in the specimen.

scholarly journals Giant antrochoanal polyp: Case report and literature review

2014 ◽  
Vol 67 (11-12) ◽  
pp. 410-412 ◽  
Author(s):  
Karol Canji ◽  
Slobodan Mitrovic
Keyword(s):  
Case Report ◽  
Maxillary Sinus ◽  
Common Symptom ◽  
Antrochoanal Polyp ◽  
Nasal Pyramid ◽  
The Right ◽  
Sinus Ostium ◽  
Sinus Mucosa ◽  
Endotracheal Anesthesia

Introduction. Antrochoanal polyp is a benign tumor of the maxillary sinus mucosa passing through the sinus ostium into the nasal cavity. Nasal obstruction is the most common symptom in all patients. Case Report. The authors present a case of a 28-year old female who was admitted to hospital with breathing difficulty, unilateral nasal secretion, headache and deformity of the nasal pyramid. Computerized tomography examination of the nose and paranasal sinuses indicated a possibility of giant antrochoanal polyp. The antrochoanal polyp was extirpated completely using forceps, under general endotracheal anesthesia. The length of the giant polyp was 16 cm. A follow-up examination of the nose and the right maxillary sinus was performed using a rigid endoscope, but no remains of the polyp were found. Conclusion. The authors believe that this is probably the first or a very rare published case of complete extirpation of a giant antrochoanal polyp of this size.

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. .

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