Department of ORL, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
Ann Thorac Med. 2009 Jul;4(3):133-6. doi: 10.4103/1817-1737.53353.
To evaluate and compare the clinical and the pathological characteristics of antrochoanal polyps (ACPS) in adults and children.
Medical records of 35 patients (19 children, 16 adults) operated upon for ACPS between 1995 and 2005 at an academic tertiary center were reviewed retrospectively. Demographic characteristics, clinical presentation, surgical management, histological findings and recurrence rate were compared.
Of the 35 patients, 19 (54%) were children (mean age, 12.6 years) and 16 (46%) were adults (mean age, 31.4 years). Nasal obstruction was the most common presenting symptom in both groups. The incidence of snoring and/or obstructive sleep apnea was statistically significant, more common among the pediatric age group as compared to the adult group (P =.001). Epistaxis was also found to be more common among the pediatric age group (P =.027), while sinusitis was noted to be significantly more common among the adult group (P =.019). Transnasal endoscopic removal of ACPS was performed in 12 (63.1%) children and 11 (68.7%) adults. A combined open/endoscopic approach was required in 36.9% of children and 31.3% of adults. On histologic examination, allergic ACPS (the mucosal surface is respiratory epithelium, no mucus glands, abundant eosinophils) was more common than inflammatory ACPS (the mucosal surface is respiratory epithelium, no mucus glands, abundant neutrophils) in children (2.8:1) as compared to adults (0.8:1) (P =.045). All of our patients were followed with endoscopic examination for a period ranging from 9 to 42 months (mean, 24 months). Recurrence of ACPS was identified in 2 children and 1 adult.
Antrochoanal polyps are a rare clinical entity. Children have unique clinical and pathological features as compared to adults. Endoscopic excision is safe and effective in the pediatric age group and has the capability to ensure complete removal and lower recurrence rate.
评估和比较成人和儿童的前鼻后孔息肉（ACPS）的临床和病理特征。
回顾性分析了 1995 年至 2005 年间在一家学术性三级中心接受 ACPS 手术的 35 名患者（19 名儿童，16 名成人）的病历。比较了人口统计学特征、临床表现、手术管理、组织学发现和复发率。
35 名患者中，19 名（54%）为儿童（平均年龄 12.6 岁），16 名（46%）为成人（平均年龄 31.4 岁）。鼻腔阻塞是两组最常见的首发症状。儿童组中打鼾和/或阻塞性睡眠呼吸暂停的发生率明显更高，与成人组相比具有统计学意义（P =.001）。儿童组中鼻出血也更为常见（P =.027），而成人组中鼻窦炎更为常见（P =.019）。12 名（63.1%）儿童和 11 名（68.7%）成人采用经鼻内镜切除 ACPS。36.9%的儿童和 31.3%的成人需要联合开放式/内镜式手术。组织学检查显示，与成人（0.8:1）相比，儿童中过敏性 ACPS（黏膜表面为呼吸上皮，无黏液腺，大量嗜酸性粒细胞）比炎症性 ACPS（黏膜表面为呼吸上皮，无黏液腺，大量中性粒细胞）更为常见（2.8:1）（P =.045）。我们所有的患者均接受了内镜检查随访，随访时间为 9 至 42 个月（平均 24 个月）。2 名儿童和 1 名成人复发 ACPS。
前鼻后孔息肉是一种罕见的临床实体。与成人相比，儿童具有独特的临床和病理特征。在儿童中，内镜切除是安全有效的，能够确保完全切除和降低复发率。
