Diagnostic challenges of antrochoanal polyps: A review of sixty‐one cases

Choudhury, Natasha; Hariri, Ahmad; Saleh, Hesham; Sandison, Ann

doi:10.1111/coa.12993

Cited by 16 publications

(11 citation statements)

References 8 publications

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“…7.8% of our cases were under the age of 18, coinciding with the results of Segal et al [9]. 80% were diagnosed using CRS, however 8.1% turned out to be inverted papillomas, so the pathological anatomical confirmation is very important due to the different nature of this lesion and its tendency to relapse if not properly removed [10]. No differences have been found in term of gender.…”

Section: Discussionsupporting

confidence: 88%

Clinicopathological features of 214 maxillary sinus pathologies. A ten-year single-centre retrospective clinical study

et al. 2020

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Background Diagnosis of maxillary sinus pathology must include the clinical radiological study (CRS) and histopathological analysis. The aim of this study is 1) to describe the clinicopathological features of maxillary sinus lesions, obtained successively in a single medical centre over the last 10 years and 2) to determine the sensitivity and specificity for the diagnosis of malignant lesions based exclusively on the CRS. Methods It is a single-centre observational retrospective clinical study on patients who attended the University Hospital Complex of Santiago de Compostela (CHUS) with sinus pathologies during the period of 2009–2019. Results The sample consisted of 133 men (62.1%) and 81 women (37.9%), with an average age of 46.9 years (SD = 18.8). In terms of frequency, the most frequent pathology was the unspecified sinusitis (44.4%), followed by polyps (18.2%), malignant tumours (9.8%), inverting papilloma (7.5%), fungal sinusitis (4.7%), cysts (3.7%), benign tumours (2.3%), mucocele (2.3%) and other lesions (1.9%). Cysts and benign tumours were diagnosed earliest Vs malignant tumours (65.2 years (SD = 16.1)) were diagnosed the latest (p < 0.001). Based only on the CRS for malignancies, diagnostic indexes were 71.4% sensitivity and 97.9% specificity, with a Kappa value of 0.68 with (p < 0.001). Conclusion Maxillary sinus pathology is very varied with therapeutic and prognostic repercussions. CRS is sometimes insufficient and histopathological confirmation is essential.

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Section: Discussionsupporting

confidence: 88%

Clinicopathological features of 214 maxillary sinus pathologies. A ten-year single-centre retrospective clinical study

et al. 2020

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“…13,15 Antrochoanal polyp may mimic a wide range of pathologies, although certain clinical and radiological features should raise the index of suspicion. 16…”

Section: Discussionmentioning

confidence: 99%

Combined approach for paediatric recurrent antrochoanal polyp: a single-centre case series of 27 children

et al. 2019

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ObjectiveTo compare functional endoscopic sinus surgery with a combined approach (functional endoscopic sinus surgery plus Caldwell–Luc procedure) for the treatment of paediatric antrochoanal polyp, in terms of antrochoanal polyp recurrence and safety.MethodThis retrospective case series comprises 27 paediatric patients with recurrent antrochoanal polyp, treated from January 2010 to January 2018.ResultsThe average age of the patients at the time of diagnosis was 10.4 ± 2.49 years. The recurrence rate after functional endoscopic sinus surgery alone was 72.9 per cent, compared with 12.5 per cent after functional endoscopic sinus surgery plus the Caldwell–Luc procedure (p < 0.00001). No complications were reported during surgery or follow up.ConclusionThe correct identification of the origin of the antrochoanal polyp and an adequate returning of maxillary ventilation by widening the ostium can prevent recurrences. Although functional endoscopic sinus surgery continues to be the ‘gold standard’ for antrochoanal polyp treatment, in cases of revision surgery, a combined approach could ensure the complete removal of the polyp through the two openings.

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“…Clinically, an ACP appears as a bright, grey or pinkish mass in the middle meatus and nasal cavity protruding posteriorly to the choana. Computed tomography (CT) can help to assess its nature, showing a soft tissue mass filling the maxillary sinus and growing through the accessory ostium into the middle meatus and the posterior choana 4 .…”

Section: Introductionmentioning

confidence: 99%

“…To prevent recurrence of the disease, it is important to avoid a simple polypectomy and to remove the underlying mucosa at the site of origin of the ACP with minimal interruption of the normal sinus physiology 6 . However, it is not always possible to determine the point of attachment preoperatively due to the presence of coexistent sinonasal mucosal disease 4 , 6 and, consequently, to precisely plan the most suitable surgical approach.…”

Section: Introductionmentioning

confidence: 99%

A comparison of two endoscopic techniques for the treatment of antrochoanal polyps

Al-Balas

Farneti

Bellusci

et al. 2020

Acta Otorhinolaryngol Ital

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SUMMARY An antrochoanal polyp (ACP) is a benign sinonasal lesion that originates from the mucosa of the maxillary sinus. In order to avoid any recurrence of disease, it is important to choose the best surgical approach for removal of ACP with respect to the site of attachment within the maxillary sinus walls. A retrospective cohort study was carried out by analysing a database of 82 patients who were operated on for ACPs in the Ear, Nose and Throat (ENT) clinics of both Sant’Orsola-Malpighi Polyclinic Hospital and Bellaria Hospital in Bologna, Italy from January 2001 to November 2017 to compare the rate of recurrence of ACPs after surgical removal using two different approaches. The first technique was endoscopic antrochoanal polypectomy with middle meatal antrostomy and the second was endoscopic antrochoanal polypectomy combined with both middle meatal antrostomy and a minimal access through the inferior meatus. A total of 49 patients were operated on with an endoscopic polypectomy with middle meatal antrostomy and 18.4% experienced a recurrence. The remaining 33 patients underwent endoscopic polypectomy with combined middle meatal antrostomy and access through the inferior meatus with a recurrence rate of 3%. The difference between the two groups was statistically significant (p = 0.0441). The strategy of the authors, namely combining medial antrostomy with a small inferior meatus access, was associated with a lower rate of recurrence and no increased morbidity in the short- or long-term.

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Diagnostic challenges of antrochoanal polyps: A review of sixty‐one cases

Cited by 16 publications

References 8 publications

Clinicopathological features of 214 maxillary sinus pathologies. A ten-year single-centre retrospective clinical study

Clinicopathological features of 214 maxillary sinus pathologies. A ten-year single-centre retrospective clinical study

Combined approach for paediatric recurrent antrochoanal polyp: a single-centre case series of 27 children

A comparison of two endoscopic techniques for the treatment of antrochoanal polyps

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