Endoscopic surgery in pediatric recurrent antrochoanal polyp, rule of wide ostium.

OBJECTIVE

To evaluate the use of wide middle meatal antrostomy in recurrent antrochoanal polyp (ACP) in children as regard technical difficulty, efficacy, and safety in children.

STUDY

DESIGN

Retrospective study.

PATIENTS AND

METHODS

In a retrospective study, 12 children with unilateral recurrent ACP (5 left-sided, 7 right-sided). All the ACPs were documented by preoperative endoscopy and computer tomographic (CT) scans. All cases were treated using endoscopic wide middle meatal antrostomy. The average age at the onset of symptoms was 9.3 years (median age: 10 years; range: 6-15 years).

RESULTS

Postoperative improvement in all cases was achieved using both subjective measures (symptoms improvement) and objective measures (radiological and endoscopical). No postoperative complications or recurrence during the follow up period.

CONCLUSIONS

Endoscopic wide middle meatal antrostomy is a useful and easily applicable technique to manage recurrent antrochoanal 3 polyp in children. Managing associated pathology as turbinate hypertrophy, associated adenoids, anterior ethmoidectomy, uncinectomy and endoscopic limited septoplasty should be put in mind in order to improve ventilations. Powered instrumentations, angled endoscopes (45 and 70°) and angled instrumentations can assure complete clearance of the polyp by identifying the origin of polyp in maxillary antrum.