Antrochoanal polyp: clinical presentation and retrospective comparison of endoscopic sinus surgery and endoscopic sinus surgery plus mini-Caldwell surgical procedures

• Published in: The Journal of craniofacial surgery Vol. 25; no. 5; p. 1779
• Main Authors: Kelles, Mehmet, Toplu, Yuksel, Yildirim, Ilhami, Okur, Erdogan
• Format: Journal Article
• Language: English
• Published: United States 01.09.2014
• Subjects: Adolescent; Adult; Child; Chronic Disease; Endoscopy - methods; Female; Humans; Male; Maxillary Sinus - surgery; Middle Aged; Nasal Polyps - surgery; Otorhinolaryngologic Surgical Procedures - methods; Paranasal Sinus Diseases - surgery; Paranasal Sinuses - pathology; Recurrence; Retrospective Studies; Young Adult
• ISSN: 1536-3732
• DOI: 10.1097/SCS.0000000000000901

Antrochoanal polyp is a benign polypoid lesion orginating from the maxillary sinus antrum and extending to the choana. Our aim was to assess the clinical presentation and associated rhinological findings of antrochoanal polyp patients and to evaluate results of 2 surgical treatments termed endoscopic sinus surgery (ESS) and ESS plus mini-Caldwell operation. The study included 46 patients. Factors such as patient age, sex, history of chronic sinusitis, allergic rhinitis, septal deviations, chonca bullosa, turbinate hypertrophy, and the origin of the polyp were assessed. We also evaluated ESS and ESS plus mini-Caldwell surgical procedures for recurrences, synechia, bleeding, and ostium stenosis. Overall, there were 27 men and 19 women. The ESS approach was used in 26 cases, and 20 cases had combined ESS and mini-Caldwell procedures. The statistical significant difference between the 2 groups was only recurrence (P < 0.05). In the ESS group, bleeding, synechia, and ostium stenosis were seen more than in the ESS + mini-Caldwell group, but there was no significant difference between the 2 groups in bleeding, synechia, and ostium stenosis (P > 0.05). We thought that lower rate of recurrence found in ESS + Caldwell group in this study was associated with better visualization of the maxillary sinus walls and, therefore, easier resection of the remnant polyp. We concluded that higher incidences of bleeding and synechia were related to the mucosal damage occurring in the septum and the inferior concha due to excessive manipulation of endoscope and surgical instruments.