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 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 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.

scholarly journals Long-Term Follow-Up After Maxillary Sinus Balloon Sinuplasty and ESS

2021 ◽  
pp. 014556132098603
Author(s):  
Anni Koskinen ◽  
Marie Lundberg ◽  
Markus Lilja ◽  
Jyri Myller ◽  
Matti Penttilä ◽  
...  
Keyword(s):  
Maxillary Sinus ◽  
Revision Surgery ◽  
University Hospital ◽  
Sinus Surgery ◽  
Control Group ◽  
University Hospitals ◽  
Balloon Sinuplasty ◽  
Long Term Follow Up

Objectives: The aim of this controlled follow-up study was to compare the need for revision surgery, long-term efficacy, and satisfaction in chronic rhinosinusitis patients who had undergone maxillary sinus operation with either balloon sinuplasty or traditional endoscopic sinus surgery (ESS) technique. Methods: Thirty-nine ESS patients and 36 balloon patients of our previously described cohort, who had been primarily operated in 2008 to 2010, were contacted by phone. Symptoms, satisfaction, and need for revision surgery were asked. In addition, we collected data of patients who had undergone primary maxillary sinus balloon sinuplasty in the Helsinki University Hospital during the years 2005 to 2019. As a control group, we collected data of patients who had undergone primary maxillary sinus ESS at 3 Finnish University Hospitals, and 1 Central Hospital in years 2005, 2008, and 2011. Results: Altogether, 77 balloon patients and 82 ESS patients were included. The mean follow-up time was 5.3 years in balloon group and 9.8 years in ESS group. Revision surgery was performed on 17 balloon patients and 6 ESS patients. In the survival analysis, the balloon sinuplasty associated significantly with a higher risk of revision surgery compared to ESS. According to the phone interviews, 82% of ESS patients and 75% of balloon patients were very satisfied with the primary operation. Conclusion: Although the patient groups expressed equal satisfaction and change in symptoms after the operations, the need for revision surgery was higher after balloon sinuplasty than after ESS. This should be emphasized when counselling patients regarding surgical options.

Reevaluation of Maxillary Sinus Surgery: Experimental Study in Rabbits

1989 ◽  
Vol 98 (11) ◽  
pp. 901-906 ◽  
Author(s):  
David W. Kennedy ◽  
Hisham Shaalan
Keyword(s):  
Maxillary Sinus ◽  
Complex Disease ◽  
Mucociliary Clearance ◽  
Functional Endoscopic Sinus Surgery ◽  
Sinus Surgery ◽  
Control Group ◽  
Ostiomeatal Complex ◽  
The Status ◽  
Sinus Ostium ◽  
Sinus Mucosa

Functional endoscopic sinus surgery concentrates primarily on the removal of ostiomeatal complex disease. When required, maxillary sinus ostioplasty is performed. However, surgical widening of a sinus ostium is contrary to common precepts. A study therefore was performed to reevaluate the effects of antrostomies and of intrasinus mucosal removal. Widening of the natural ostium, a separate antrostomy at some distance from the ostium, or radical mucosal removal was performed on 30 rabbits. Fifteen sinuses were used as controls. After 6 to 8 weeks the status of the sinus mucosa and mucociliary clearance was studied. The study confirmed that mucociliary clearance continued toward the natural ostium following inferior antrostomy. Following widening of the natural ostium, mucociliary clearance through the ostium redeveloped in 11 of 18 sinuses but was typically imperfect. There were no cases of ostial closure; however, the incidence of infection was significantly higher in all three experimental groups than in the control group.

scholarly journals Disease Management in the Fungal Body of the Maxillary Sinus in People with Planned Dental Implantation

2021 ◽  
Vol 6 (3) ◽  
pp. 206-211
Author(s):  
Ya. V. Shkorbotun ◽  
◽  
Keyword(s):  
Maxillary Sinus ◽  
Complete Removal ◽  
Sinus Surgery ◽  
Endoscopic Endonasal ◽  
Main Method ◽  
Maxillary Bone ◽  
Fungal Ball ◽  
Dental Implantation ◽  
Group 2 ◽  
Maxillary Sinuses

The fungal ball is the most common clinical form of fungal etiology sinusitis. The main method of treatment of patients with this pathology is surgery. Achieving complete removal of the fungal body is important, especially in patients who will have planned dental implantation. Among the accesses to the maxillary sinus in cases of the fungal body of the sinus, the most common one is through the middle meatus, but it does not provide visual control of the anterior parts of the sinus during the intervention. The use of modified infraturbinal access provides better opportunities for examination of the anterior parts of the maxillary sinus. The purpose of the study is to increase the effectiveness of surgical treatment of patients with fungal bodies of the maxillary sinus by optimizing access during endoscopic endonasal intervention. Materials and methods. The data of 113 patients with fungal ball of maxillary sinuses who underwent sinusotomy in preparation for dental implantation were analyzed. Cone beam computed tomography of paranasal sinuses of patients were performed twice – before functional endoscopic sinus surgery and before subantral augmentation of the maxillary bone. Group 1 included 78 patients to whom the fungal balls were removed from the sinus through the middle nasal meatus, group 2 – 35 patients to whom, in cases when it was impossible to visually confirm the completeness of removal of the fungal ball from the anterior area of the sinus, an additional infraturbinal approach was performed in our modification. Results and discussion. According to tomography before rhinosurgery it was established that "blackout" of more than 60% of the sinus space is observed in 50.5% of patients with fungal bodies, with the vast majority of patients (88.1%) fungal bodies in the maxillary sinus are located in its lower parts and spread forward from the nasolacrimal canal level. During sinus rehabilitation, the need for additional infraturbinal access arose in 5 (14.3%) patients of the second group. As a result of its performance in all 5 operated patients polyposis-altered tissues were found in "blind zones" and in 2 (5.7%) – there were also remains of a fungal body. Residual fungal bodies in the maxillary sinus were detected in 3 (3.9% CI 95% – 0.01; 11.6) patients of the first group, and were not observed in the second group. All cases of residual fungal masses in the sinus were not accompanied by specific complaints. A revision of sinusitis with fungal masses removing was performed on 3 patients due to the appearance of residual fungal bodies by preformed antrostomy with local anesthesia. Conclusion. Anthrostomy using additional endoscopic infraturbinal access when removing the fungal body from the lower anterior maxillary sinus is the optimal combined access that allows maximum visualization of the maxillary sinus and avoid recurrence of the disease

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.

scholarly journals Invasive Aspergillosis of Right Maxillary Sinus with Orbital Extension in an Immunocompetent Individual

2021 ◽  
Author(s):  
Sachin Daigavane ◽  
Madhumita Prasad ◽  
Sana Beg ◽  
Jigna Motwani
Keyword(s):  
Optic Nerve ◽  
Invasive Aspergillosis ◽  
Maxillary Sinus ◽  
Sinus Surgery ◽  
Lateral Side ◽  
Normal Colour ◽  
Eye Examination ◽  
Intravenous Amphotericin ◽  
Unilateral Proptosis

Secondary involvement of orbit in aspergillosis following paranasal sinus fungal infection is rare. A case of invasive aspergillosis of right maxillary sinus in a 31-year-old immunocompetent male patient was referred to Ophthalmology OPD with unilateral proptosis. Patient developed proptosis in right eye since six months, which was insidious in onset, progressive, not associated with painful movements. It showed regression since last one month. On examination, best corrected visual acuity was 6/12 in right eye with light projection accurate in all quadrants on presentation, with progressive diminution of vision over 15 days, normal colour vision, pupil was normal in size, reacting to light. Extraocular movements were reduced on lateral side. Left eye examination was within normal limit. Magnetic resonance imaging showed involvement of intra and extraconal compartment upto apex of orbit of right eye, pushing optic nerve medially, with erosion of lamina papyrecea. Intravenous amphotericin B was started and functional endoscopic sinus surgery with maxillary sinus debridement was done. Regular follow-up was kept to prevent the optic nerve involvement.

The Influence of the Size of the Maxillary Sinus Ostium on the Nasal and Sinus Nitric Oxide Levels

2002 ◽  
Vol 16 (5) ◽  
pp. 261-264 ◽  
Author(s):  
Ravi K.D.R.A. Kirihene ◽  
Guy Rees ◽  
Peter-John Wormald
Keyword(s):  
Nitric Oxide ◽  
Nasal Cavity ◽  
Maxillary Sinus ◽  
Endoscopic Sinus Surgery ◽  
Antibacterial Properties ◽  
Topical Steroid ◽  
Recurrent Infection ◽  
Sinus Surgery ◽  
Breath Holding ◽  
Sinus Ostium

Background Nitric oxide (NO) is produced in significant quantities in the nasal sinuses and is thought to have a beneficial effect on the mucociliary transport of the sinuses and nose and to have significant antibacterial properties that contribute to the health of the sinuses. Recently, the concept of “mini-functional endoscopic sinus surgery” has been introduced where the uncinate is removed without enlargement of the maxillary ostium. Although no scientific evidence has been published, enlargement of the ostium is thought to possibly disrupt the mucociliary pathway and decrease the concentration of NO in the nose and sinuses. The aim of this study was to establish the effect of enlargement of the maxillary ostium on sinus and nasal NO. Methods Twenty-nine patients who were post-endoscopic sinus surgery were included with 52 who were maxillary sinus ostia cannulated. There were 22 large maxillary sinus ostia and 30 small ostia. Smoking, allergy status, and topical steroid use were recorded. NO levels were measured in the nose and maxillary sinus after decongestion with patients mouth breathing and breath holding. Results This study shows that enlargement of the maxillary sinus ostium above its normal size (20 mm2) produces a significant decrease in both the maxillary sinus and the nasal cavity NO levels. In addition, the size of the ostium showed a significant correlation to the sinus NO level. Use of topical nasal steroid sprays and topical decongestants were shown to effect NO levels in the sinuses and nasal cavity. The lowered levels of NO were found irrespective of the technique of measurement of the NO. Conclusions The effect of this lowered NO level on the susceptibility of the maxillary sinuses to recurrent infection is yet to be determined.

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.

Bilateral Antrochoanal Polyp with Diabetes: A Rare Presentation of Cystic Fibrosis

2010 ◽  
Vol 3 (3) ◽  
pp. 173-176
Author(s):  
Monica Gupta ◽  
Manish Gupta
Keyword(s):  
Cystic Fibrosis ◽  
Endoscopic Sinus Surgery ◽  
English Literature ◽  
Functional Endoscopic Sinus Surgery ◽  
Sinus Surgery ◽  
Adolescent Male ◽  
Antrochoanal Polyp ◽  
Rare Presentation ◽  
First Case

Abstract Bilateral antrochoanal (AC) polyps have been rarely reported in english literature. Here we report the first case of an adolescent male with bilateral AC polyps, cystic fibrosis and diabetes. The case was managed successfully by functional endoscopic sinus surgery (FESS). The patient has been under follow-up for the last six months with no signs of recurrence.

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