Endoscopic Excision of the Antrochoanal Polyp

Objective: To evaluate the effectiveness of endoscopic excision of the antrochoanal polyp and its role in decreasing the recurrence rate. Design: Retrospective M e t h o d s : Medical re c o rds of thirty patients with antrochoanal polyp (ACP) diagnosed and treated at King Abdulaziz University Hospital (KAUH) in Riyadh between January 1996 and December 2002 were retrospectively studied. Factors such as gender, age, presenting complaints, findings, pathology, management and recurrence rates were included in this study. Results: Out of thirty patients, 17 were male and their ages ranged from six to 45 years with a mean age of 17.37 years. Nasal obstruction was the most common presenting symptom. Endoscopic transnasal removal of ACP was performed in 25 patients as primary surgery. Revision endoscopic removal was done in three patients and two of those who had failure of revision surgery had combined transcanine and endonasal endoscopic removal. All candidates had follow up from nine to 42 months with mean average time of 24 months. Recurrence was confirmed in five patients (four of them after primary surgery and one patient after revision s u rgery). However those who underwent combined approach had no recurrence. Conclusion: Endoscopic approach compared to previous modalities of treatment has the capability to ensure complete removal of the ACP and decrease its rate of re c u r rence. Its safety in children is considerable in capable hands. Power instrumentation with combined transcanine and middle meatal antrostomy approach is another way to deal with difficult cases and those with recurrence.