Abstract
An antrochoanal polyp (ACP) is a benign polypoid lesion originating from the maxillary sinus and extending to the choana. The objective of our study is to assess etiological and associated features of ACPs, and outcome following surgical treatment. Thirty-four patients who had received surgical treatment for ACPs were followed for 35 ± 17.7 months. Factors including patient age, gender, history of allergic rhinitis, chronic sinusitis, nasal septal deviation, turbinate hypertrophy, concha bullosa, accessory ostia, as well as the origin of the polyp, the surgical technique used and any recurrence, were evaluated. Overall, there were 12 females and 22 males. Mean age was 24.94 ± 8.08. Septal deviation was present in 50 %, turbinate hypertrophy in 32.3 %, concha bullosa in 17.6 %, mucous retention cyst in 32.3 %, allergic rhinitis in 44.11 %, and chronic sinusitis in 20.5 %. An accessory ostia was observed in 97.05 %. The functional endoscopic sinus surgery (FESS) approach was used in 31 cases, and three cases had combined FESS and Caldwell Luc procedures. The mean follow-up time was 35.8 ± 17.7 months. Two cases, who had been treated with FESS alone, experienced a recurrence. In conclusion, the commonest predisposing factors for ACPs are chronic inflammatory pathologies such as chronic sinusitis and allergic rhinitis. ACP left the maxillary sinus via an accessory ostium in 97.5 % of the cases. The FESS procedure is a safe and reliable method, and can be combined with the Caldwell Luc procedure when the origin of the maxillary component cannot be properly cleaned. In order to prevent recurrence, total extirpation of the maxillary component is essential.
Similar content being viewed by others
References
Killian G (1906) The origin of choanal polypi. Lancet 2:81–82
Lee TJ, Huang SF (2006) Endoscopic sinus surgery for antrochoanal polyps in children. Otolaryngol Head Neck Surg 135(5):688–692
Cook PR, Davis WE, McDonald R et al (1993) Antrochoanal polyposis: a review of 33 cases. Ear Nose Throat J 72(6):401–2, 404–10
Ozdek A, Samim E, Bayiz U et al (2002) Antrochoanal polyps in children. Int J Pediatr Otorhinolaryngol 65(3):213–218
Myatt HM, Cabrera M (1996) Bilateral antrochoanal polyps in a child: a case report. J Laryngol Otol 110(3):272–274
Basu SK, Bandyopadhyay SN, Bora H (2001) Bilateral antrochoanal polyps. J Laryngol Otol 115(7):561–562
Ozcan C, Zeren H, Talas DU, Kucukoglu M, Gorur K (2005) Antrochoanal polyp: a transmission electron and light microscopic study. Eur Arch Otorhinolaryngol 262(1):55–60
Berg O, Carenfelt C, Silfversward C, Sobin A (1988) Origin of the choanal polyp. Arch Otolaryngol Head Neck Surg 114:1270–1271
Frosini P, Picarella G, De Campora E (2009) Antrochoanal polyp: analysis of 200 cases. Acta Otorhinolaryngol Ital 29(1):21–26
Stammberger H, Hawke M (1993) Essentials of functional endoscopic sinus surgery. Mosby, St Louis, pp 103–105
Yuca K, Bayram I, Kiroglu AF, Etlik O, Cankaya H, Sakin F et al (2006) Evaluation and treatment of antrochoanal polyps. J Otolaryngol 35(6):420–423
Chen JM, Schloss MD, Azouz ME (1989) Antro-choanal polyp: a 10-year retrospective study in the pediatric population with a review of the literature. J Otolaryngol 18(4):168–172
Woolley AL, Clary RA, Lusk RP (1996) Antrochoanal polyps in children. Am J Otolaryngol 17(6):368–373
Franche GL, Granzotto EH, de Borba AT, Hermes F, Saleh Cde S, de Souza PA (2007) Endoscopic polypectomy with middle meatal antrostomy for antrochoanal polyp treatment. Braz J Otorhinolaryngol 73(5):689–692
Bozzo C, Garrel R, Meloni F, Stomeo F, Crampette L (2007) Endoscopic treatment of antrochoanal polyps. Eur Arch Otorhinolaryngol 264(2):145–150
Orvidas LJ, Beatty CW, Weaver AL (2001) Antrochoanal polyps in children. Am J Rhinol 15(5):321–325
Rodgers GK, Chan KH, Dahl RE (1991) Antral choanal polyp presenting as obstructive sleep apnea syndrome. Arch Otolaryngol Head Neck Surg 117(8):914–916
Salib RJ, Sadek SA, Dutt SN, Pearman K (2000) Antrochoanal polyp presenting with obstructive sleep apnoea and cachexia. Int J Pediatr Otorhinolaryngol 54(2–3):163–166
Min YG, Chung JW, Shin JS, Chi JG (1995) Histologic structure of antrochoanal polyps. Acta Otolaryngol 115(4):543–547
Jang YJ, Rhee CK, Oh CH, Ryoo HG, Kim HG, Ha M (2000) Arachidonic acid metabolites in antrochoanal polyp and nasal polyp associated with chronic paranasal sinusitis. Acta Otolaryngol 120(4):531–534
Sunagawa M, Kinjoh K, Nakamura M, Kosugi T (1999) Urokinase-type plasminogen activator and plasminogen activator inhibitor antigen in tissue extracts of paranasal sinus mucous membranes affected by chronic sinusitis and antrochoanal polyps. Eur Arch Otorhinolaryngol 256(5):237–241
Sato K, Nakashima T (2000) Endoscopic sinus surgery for chronic sinusitis with antrochoanal polyp. Laryngoscope 110(9):1581–1583
Ozer F, Ozer C, Cagici CA, Canbolat T, Yilmazer C, Akkuzu B (2008) Surgical approaches for antrochoanal polyp: a comparative analysis. B-ENT 4(2):93–99
Atighechi S, Baradaranfar MH, Karimi G, Jafari R (2009) Antrochoanal polyp: a comparative study of endoscopic endonasal surgery alone and endoscopic endonasal plus mini-Caldwell technique. Eur Arch Otorhinolaryngol 266(8):1245–1248
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Balikci, H.H., Ozkul, M.H., Uvacin, O. et al. Antrochoanal polyposis: analysis of 34 cases. Eur Arch Otorhinolaryngol 270, 1651–1654 (2013). https://doi.org/10.1007/s00405-012-2274-2
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00405-012-2274-2