Skip to main content
The Egyptian Journal of Otolaryngology
Download PDF

Study of recurrent antrochoanal polyps: causes and how to minimize recurrence

The Egyptian Journal of Otolaryngology volume 28, pages 75–79 (2012)Cite this article

En

Abstract

Objectives

To conduct a prospective study investigating the causes of repeated recurrences of antrochoanal polyps (ACPs) in an attempt to minimize recurrence.

Materials and methods

Twenty-two patients, with an established diagnosis of a recurrent ACP, were included in the study. A subjective visual analogue scale, endoscopic examination, and computed tomography, both coronal and axial, were performed preoperatively.

Endoscopic sinus surgery was performed in all cases, combined with transcanine antrostomy in some cases, aiming at the complete removal of the polyp.

Postoperatively, improvements in clinical symptoms and endoscopic findings were evaluated using visual analogue scale and endoscopic examination.

Results

The study included 22 patients with recurrence of an ACP one to five times (a total of 38 previous surgeries). The endoscopic transnasal approach was used in 14 cases, whereas a combined endoscopic transcanine approach was used in eight cases. The success rate was 85.7% in the endoscopic transnasal approach and 100% in the combined endoscopic transcanine approach. All patients showed a subjective improvement after surgery but endoscopic recurrence was detected only in two cases after 18–24 months of follow-up.

Conclusion

The main cause of recurrence of ACPs is incomplete removal. Every effort should be made to completely remove the polyp (especially antral part) to avoid recurrence. Endoscopically, this can be performed using 30–45 and 70π telescopes, angled forceps, and performing a very wide middle meatal antrostomy and may be assisted with a canine fossa puncture. The operation preserves healthy antral mucosa and promotes epithelization and mucociliary clearance of the antrum.

References

  1. Lopatin A, Bykova V, Piskunov G. Choanal polyps: one entity, one surgical approach? Rhinology. 1997; 35: 79–83.

    CAS  PubMed  Google Scholar 

  2. Frosini P, Picarella G, De Campora E. Antrochoanal polyp: analysis of 200 cases. Acta Otorhinolaryngol Ital. 2009; 29: 21–26

    CAS  PubMed Central  PubMed  Google Scholar 

  3. De Freitas MR, Giesta RP, Pinheiro SD, Da Silva VC. Antrochoanal polyp: a review of sixteen cases. Braz J Otorhinolaryngol. 2006; 72: 831–835

    Article  PubMed  Google Scholar 

  4. Kaushal A, Vaid L, Singh PP. Antrochoanal polyp–validating its origin and management by endonasal endoscopic sinus surgery (EESS). Indian J Otolaryngol Head Neck Surg. 2004; 56: 273–279

    PubMed Central  PubMed  Google Scholar 

  5. Woolley AL, Clary RA, Lusk RP. Antrochoanal polyps in children. Am J Otolaryngol. 1996; 17: 368–373

    Article  CAS  PubMed  Google Scholar 

  6. Franche GLDS, Granzotto EH, De Borba AT, Hermes F, Saleh CDS, De Souza PA. Endoscopic polipectomy with middle meatal antrostomy for antrochoanal polyp treatment. Braz J Otorhinolaryngol. 2007; 73: 689–692

    Article  PubMed  Google Scholar 

  7. Hong SK, Min YG, Kim CN, Byun SW. Endoscopic removal of the antral portion of antrochoanal polyp by powered instrumentation. Laryngoscope. 2001; 111: 1774–1778

    Article  CAS  PubMed  Google Scholar 

  8. Lee CH, Lee SJ, Min YG, Kim JW. Endoscopic removal of antrochoanal polyp. J Rhinol. 1997; 4: 100–103

    Google Scholar 

  9. Lund VJ, Kennedy DW. Quantification for staging sinusitis. The Staging and Therapy Group. Ann Otol Rhinol Laryngol Suppl. 1995; 167: 17–21

    Article  CAS  PubMed  Google Scholar 

  10. Stammberger H, Posawetz W. Functional endoscopic sinus surgery. Concept, indications and results of the Messerklinger technique. Eur Arch Otorhinolaryngol. 1990; 247: 63–76

    Article  CAS  PubMed  Google Scholar 

  11. Özcan C, Zeren H, Talas DÜ, Küçükoğlu M, Görür K. Antrochoanal polyp: a transmission electron and light microscopic study. Eur Arch Otorhinolaryngol. 2005; 262: 55–60

    Article  PubMed  Google Scholar 

  12. Gendeh BS, Long YT, Misiran K. Antrochoanal polyps: clinical presentation and the role of powered endoscopic polypectomy. Asian J Surg. 2004; 27: 22–25

    Article  PubMed  Google Scholar 

  13. Başak S, Karaman CZ, Akdilli A, Metin KK. Surgical approaches to antrochoanal polyps in children. Int J Pediatr Otorhinolaryngol. 1998; 46: 197–205

    Article  PubMed  Google Scholar 

  14. Cook PR, Davis WE, McDonald R, McKinsey JP. Antrochoanal polyposis: a review of 33 cases. Ear Nose Throat J. 1993; 72: 401–410

    Article  CAS  PubMed  Google Scholar 

  15. Schramm VL Jr, Effron MZ. Nasal polyps in children. Laryngoscope. 1980;90:1488–1495

    PubMed  Google Scholar 

  16. Sato K, Nakashima T. Endoscopic sinus surgery for chronic sinusitis with antrochoanal polyp. Laryngoscope. 2000; 110: 1581–1583

    Article  CAS  PubMed  Google Scholar 

  17. Lee TJ, Huang SF. Endoscopic sinus surgery for antrochoanal polyps in children. Otolaryngol Head Neck Surg. 2006; 135: 688–692

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Otolaryngology and Head & Neck Surgery, Tanta University Hospitals, 61 Kafr Esam Street, El Nadi Square, 31516, Tanta, Egypt

    Magdy Eisa Saafan MSc, MD & Mohamed Osama Tomoum

Authors
  1. Magdy Eisa Saafan MSc, MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Mohamed Osama Tomoum
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Magdy Eisa Saafan MSc, MD.

Additional information

Magdy Eisa Saafan takes responsibility for the integrity of the content of the paper.

Conflicts of interest

There are no conflicts of interest.

Rights and permissions

This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Saafan, M.E., Tomoum, M.O. Study of recurrent antrochoanal polyps: causes and how to minimize recurrence. Egypt J Otolaryngol 28, 75–79 (2012). https://doi.org/10.7123/01.EJO.0000413106.07357.c9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.7123/01.EJO.0000413106.07357.c9

Keywords