Surgical approaches to antrochoanal polyps in children

Abstract 

Antrochoanal polyps (ACP) represent 4–6% of all nasal polyps in the general population, but this proportion increases to 33% in the pediatric group. The aim of this study is to discuss clinical and radiological findings, and some different surgical approaches with their results in the pediatric patients. This study consists of eight children with ACP diagnosed by means of clinical examination, nasal endoscopy and computed tomography. One patient was treated only with simple polypectomy. In five patients, transcanine sinuscopy (TS) was added to functional endoscopic sinus surgery. Four of the patients underwent anterior ethmoidectomy and uncinectomy. Middle meatal antrostomy was applied to two of them. No recurrence was encountered within 5–30 months. The decision for the appropriate type of surgery for ACP is influenced by factors such as patient's age, other accompanying sinus pathologies, recurrence after previous surgery, and the possibility of total excision. In patients carrying the risk of recurrence, it is especially important to remove the polyp completely and manage other sinus pathologies, as well as avoiding an unnecessarily expanded operation. In selected patients, we believe that TS may be adequate in totally removing ACP.

Keywords:  Antrochoanal polyp, Pediatric, Surgery, Diagnosis, Tornwaldt's cyst