Skip to main content
Log in

Endoscopic management of antrochoanal polyps: a single UK centre’s experience

  • Rhinology
  • Published:
European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

Abstract

Antrochoanal polyps (ACPs) are benign lesions that originate from the mucosa of the maxillary sinus, and extend into the nasal cavity to reach the choana and nasopharynx. The treatment of ACPs is surgical, with a number of different surgical techniques having been described. We describe the first case series of ACPs from the UK and the endoscopic surgical technique that we have employed. A retrospective case note review of patients with ACPs managed under the care of the senior author was conducted. Demographic and clinical data for all patients were reviewed. The main outcome parameter measured was any sign of recurrence. A total of 29 consecutive patients were included for analysis from a 5-year study period, with 19 males and 10 females, and a mean age of 37.4 ± 13.6 years. Four patients within our group were referred to us with recurrent ACPs for revision surgery. All patients underwent surgery via the same endoscopic technique. The mean follow-up period was 14.7 ± 16.9 months, with an average follow-up of 22.5 months for the four revision cases. There were no recurrences in any of our patients. We describe the first reported series of endoscopic sinus surgery for antrochoanal polyps in the UK, and the largest worldwide series described for endoscopic management of ACPs in adults. We have had no recurrent cases, with a mean follow-up period of 14.7 months.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Palfyn J (1753) Anatomie Chirurgicale, Paris

  2. Killian G (1906) The origin of choanal polypi. Lancet 2:81–82

    Article  Google Scholar 

  3. Maldonado M, Martínez A, Alobid I, Mullol J (2004) The antrochoanal polyp. Rhinology 42(4):178–182

    PubMed  Google Scholar 

  4. Larsen K, Tos M (2002) The estimated incidence of symptomatic nasal polyposys. Acta Otolaryngol 122:179–182

    Article  PubMed  Google Scholar 

  5. Aktas D, Yetiser S, Gerek M, Can C, Kahramanyol M (1998) Antrochoanal polyposis: analysis of 16 cases. Rhinology 36:81–85

    CAS  PubMed  Google Scholar 

  6. Chen JM, Schloss MD, Azouz ME (1989) Antrochoanal polyps: a 10 year retrospective study in the pediatric population with a review of the literature. J Otolaryngol 18:168–172

    CAS  PubMed  Google Scholar 

  7. Orvidas LJ, Beatty CW, Weaver AL (2001) Antrochoanal polyps in children. Am J Rhinol 15:321–325

    CAS  PubMed  Google Scholar 

  8. Myatt HM, Cabrera M (1996) Bilateral antrochoanal polyps in a child: a case report. Laryngol Otol 110:272–274

    Article  CAS  Google Scholar 

  9. Basu SK, Bandyopadhyay SN, Bora H (2001) Bilateral antrochoanal polyps. J Laryngol Otol 115:561–562

    Article  CAS  PubMed  Google Scholar 

  10. Yilmaz YF, Titiz A, Ozcan M, Tezer MS, Ozlugedik S, Unal A (2007) Bilateral antrochoanal polyps in an adult: a case report. B-ENT 3(2):97–99

    CAS  PubMed  Google Scholar 

  11. Sousa DW, Pinheiro SD, Silva VC, Bastos JP (2011) Bilateral antrochoanal polyps in an adult. Braz J Otorhinolaryngol 77(4):539

    Article  PubMed  Google Scholar 

  12. Aydin O, Keskin G, Ustündağ E, Işeri M, Ozkarakaş H (2007) Choanal polyps: an evaluation of 53 cases. Am J Rhinol 21(2):164–168

    Article  PubMed  Google Scholar 

  13. Tysome JR, Saleh HA (2007) Sphenochoanal polyp presenting with concomitant nasal polyps. Ear Nose Throat J 86(1):50–52

    PubMed  Google Scholar 

  14. Al-Qudah MA (2010) Sphenochoanal polyp: current diagnosis and management. Ear Nose Throat J 89(7):311–317

    PubMed  Google Scholar 

  15. Min YG, Chung JW, Shin JS, Chi JG (1995) Histological structure of antrochoanal polyps. Acta Otolaryngol 115:543–547

    Article  CAS  PubMed  Google Scholar 

  16. Ozcan C, Zeren H, Talas DU, Küçükoglu M, Görür K (2005) Antrochoanal polyp: a transmission electron and light microscopic study. Eur Arch Otorhinolaryngol 262(1):55–60

    Article  PubMed  Google Scholar 

  17. Yamashiro Y, Nakamura M, Huang GW, Kosugi T (1992) Presence of urokinase-type plasminogen activator (u-PA) in tissue extracts of antrochoanal polyp. Laryngoscope 102(9):1049–1052

    Article  CAS  PubMed  Google Scholar 

  18. Mahfouz ME, Elsheikh MN, Ghoname NF (2006) Molecular profile of the antrochoanal polyp: up-regulation of basic fibroblast growth factor and transforming growth factor beta in maxillary sinus mucosa. Am J Rhinol 20(4):466–470

    Article  PubMed  Google Scholar 

  19. Topal O, Erbek SS, Kiyici H, Cakmak O (2008) Expression of metalloproteinases MMP-2 and MMP-9 in antrochoanal polyps. Am J Rhinol 22(4):339–342

    Article  PubMed  Google Scholar 

  20. Schramm VL Jr, Effron MZ (1980) Nasal polyps in children. Laryngoscope 90:1488–1495

    PubMed  Google Scholar 

  21. Ryan RE Jr, Neel HB III (1979) Antro-choanal polyps. J Otolaryngol 8:344–346

    PubMed  Google Scholar 

  22. El Guindy A, Mansour MH (1994) The role of transcanine surgery in antrochoanal polyps. J Laryngol Otol 108(12):1055–1057

    PubMed  Google Scholar 

  23. Hong SK, min YG, Kim CN, Byun SW (2001) Endoscopic removal of the antral portion of antrochoanal polyp by powered instrumentation. Laryngoscope 111(10):1774–1778

    Article  CAS  PubMed  Google Scholar 

  24. Lopatin A, Bykova V, Piskunov G (1997) Choanal polyps: one entity, one surgical approach? Rhinology 35(2):79–83

    CAS  PubMed  Google Scholar 

  25. Lee TJ, Huang SF (2006) Endoscopic sinus surgery for antrochoanal polyps in children. Otolaryngol Head Neck Surg 135(5):688–692

    Article  PubMed  Google Scholar 

  26. Cook PR, Davis WE, McDonald R, McKinsey JP (1993) Antrochoanal polyposis: a review of 33 cases. Ear Nose Throat J 72(6):401–402

    CAS  PubMed  Google Scholar 

  27. Kamel R (1990) Endoscopic transnasal surgery in antrochoanal polyps. Arch Otolaryngol Head Neck Surg 116:841–843

    Article  CAS  PubMed  Google Scholar 

  28. Loury MC, Hinkley DK, Wong W (1993) Endoscopic transnasal antrochoanal polypectomy: an alternative to the transantral approach. South Med J 86(1):18–22

    Article  CAS  PubMed  Google Scholar 

  29. Basuba NY, Kieff D (2002) Endoscopic sinus surgery for inflammatory maxillary sinus disease. Laryngoscope 112:1378–1383

    Article  Google Scholar 

  30. Lee KC, Lee SC, Ban JH, Park SO, Jin SM, Lee YB (1999) Outcomes of transnasal endoscopic sinus surgery in 62 cases of antrochoanal polyps. J Rhinol 6(1):47–52

    Google Scholar 

  31. Raji A, Essaadi M, Detsouli M, Chekkoury IA, Benchakroun (2000) The antrochoanal polyp. Acta Otorhinolaryngol Belg 54(4):473–478

    CAS  PubMed  Google Scholar 

  32. Bozzo C, Garrel R, Meloni F, Stomeo F, Crampette L (2007) Endoscopic treatment of antrochoanal polyps. Eur Arch Otorhinolaryngol 264(2):145–150

    Article  PubMed  Google Scholar 

  33. Franche GL, Granzotto EH, de Borba AT, Hermes F, Saleh Cde S, de Souza PA (2007) Endoscopic polipectomy with middle meatal antrostomy for antrochoanal polyp treatment. Braz J Otorhinolaryngol 73(5):689–692

    PubMed  Google Scholar 

  34. Ozer F, Ozer C, Cagici CA, Canbolat T, Yilmazer C, Akkuzu B (2008) Surgical approaches for antrochoanal polyp: a comparative analysis. B-ENT 4(2):93–99

    CAS  PubMed  Google Scholar 

  35. Frosini P, Picarella G, De Campora E (2009) Antrochoanal polyp: analysis of 200 cases. Acta Otorhinolaryngol Ital 29(1):21–26

    CAS  PubMed Central  PubMed  Google Scholar 

  36. Atighechi S, Baradaranfar MH, Karimi G, Jafari R (2009) Antrochoanal polyp: a comparative study of endoscopic endonasal surgery alone and endoscopic endonasal plus mini-Caldwell technique. Eur Arch Otorhinolaryngol 266(8):1245–1248

    Article  PubMed  Google Scholar 

  37. Balikci HH, Ozkul MH, Uvacin O, Yasar H, Karakas M, Gurdal M (2013) Antrochoanal polyposis: analysis of 34 cases. Eur Arch Otorhinolaryngol 270(5):1651–1654

    Article  CAS  PubMed  Google Scholar 

  38. Nikakhlagh S, Rahim F, Saki N, Mohammadi H, Maliheh YM (2012) Antrochoanal polyps: report of 94 cases and review the literature. Niger J Med 21(2):156–159

    PubMed  Google Scholar 

Download references

Conflict of interest

None declared.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Natasha Choudhury.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Choudhury, N., Hariri, A. & Saleh, H. Endoscopic management of antrochoanal polyps: a single UK centre’s experience. Eur Arch Otorhinolaryngol 272, 2305–2311 (2015). https://doi.org/10.1007/s00405-014-3163-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00405-014-3163-7

Keywords

Navigation