Endoscopic sinus surgery for antrochoanal polyps in children

Objective: The antrochoanal polyp (ACP) occurs predominantly in children and young adults. Endoscopic surgery is effective for the treatment of ACPs in adults; however, articles discussing the treatment in pediatric patients are rare. The purpose of this study was to evaluate the outcome of endoscopic treatment of ACPs in children. Study design and setting: Between January 1998 and February 2004, 26 children were prospectively enrolled in this study. Completely removing the base of the ACPs was achieved through transnasal endoscopic (TE) or combined endoscopic and transcanine (CET) approach. The CET approach was used in ACPs originated from the lateral wall of antrum. All patients received CT scan 1 year after surgery to evaluate the outcome of surgery. Results: Most of the ACPs were multitudinous and the distributions of the ACPs' origin in the maxillary sinus were as follows: posterior wall (92.3%), lateral wall (61.5%), and inferior wall (38.5). The success rate was 76.9% in the TE approach and 100% in the CET approach. Three in the TE approach recurred and all of them had concomitant rhinosinusitis. All three patients were cured in the revision CET operations. No major complications occurred. Conclusion: Endoscopic treatment of ACPs in children is safe and effective. Early diagnosis and treatment of ACPs is important because secondary rhinosinusitis can make the disease complicated and the surgeries difficult.