Endoscopic Management of Antrochoanal Polyps: A Single UK Center Experience

Abstract

Objectives:

Antrochoanal polyps (ACP) are benign lesions originating from maxillary sinus mucosa extending into the nasal cavity and choana. They are typically unilateral and rarely arise from other sinus groups. Their treatment is surgical, with various approaches reported. We aimed to evaluate the following outcome measures: 1) Report the first UK series of ACP managed endoscopically; 2) Analyze the rates of recurrences of ACPs from our case series.

Methods:

A retrospective review of adult patients with ACPs managed under our care was conducted. Demographic and clinical patient data were reviewed. The main outcome parameter measured was signs of recurrence.

Results:

23 consecutive patients were studied from an 8 year period, 14 males and 9 females, with a mean age of 37.7 +/- 14.4 years. This included 22 patients with typical ACPs and 1 with a rare sphenochoanal polyp. Two patients within our group were referred with recurrent ACPS for revision surgery. The mean follow-up was 14.8 +/- 15.3 months, with a follow-up of 24 and 12 months for the two revision cases. There were no recurrences in any of our patients.

Conclusions:

We describe the first series of endoscopic sinus surgery for ACPs from the UK. We have had no recurrent cases, with a mean follow-up period of 14.8 months. We review the literature in endoscopic management of adult ACPs and describe our own surgical technique. Our approach allows complete removal of the polyp, including its site of origin using angled endoscopes and instrumentation, to minimize recurrence.