Li Shu-hua, Shi Hong-jin, Wu Da-hai, Shi Chun-hai
Department of Otorhinolaryngology, Shenyang General Hospital of People's Liberation Army, Shenyang, China.
Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2012 Sep;47(9):764-6.
To explore the origin and etiopathogenesis of antrochoanal polyp (ACP) based on the clinical data.
Twenty-six patients with ACP were included in the study. All the ACP patients were documented by preoperative endoscopy and computer tomographic (CT) scans. All patients were treated under endonasal endoscopic surgery. The relationship between polyp in middle meatus and lesions in the antrum was observed during the surgery. Following surgical removal, the polyps and lesions in the antrum were studied under macroscopy and microscopy.
Among 26 cases with ACP, 17 cases were confirmed by preoperative endoscopic examination that polyp originating from antrum ostium, 19 cases showed intimate relationship between the polyp and antrum lesions in CT scan, and 23 cases were found that the polyp originating from the antrum cyst. The pedicle of polyp connected the cyst through autrum ostium, and the polyp existed as a part of capsule wall.
Based on the data obtained, it is tempting to suggest that the ACP mainly develops from antral cyst, an increase in pressure in cyst forced capsule wall to herniate to middle meatus through the antral ostium, and the continuous herniation and hyperplasy leading to the formation of ACP.
基于临床资料探讨上颌窦后鼻孔息肉(ACP)的起源及发病机制。
本研究纳入26例ACP患者。所有ACP患者术前行内镜检查及计算机断层扫描(CT)。所有患者均接受鼻内镜手术治疗。手术过程中观察中鼻道息肉与上颌窦病变的关系。手术切除后,对息肉及上颌窦病变进行大体及显微镜检查。
26例ACP患者中,术前内镜检查确诊17例息肉起源于上颌窦口,CT扫描显示19例息肉与上颌窦病变关系密切,23例发现息肉起源于上颌窦囊肿。息肉蒂部经上颌窦口与囊肿相连,息肉作为囊壁的一部分存在。
基于所获数据,倾向于认为ACP主要起源于上颌窦囊肿,囊肿内压力增加迫使囊壁经上颌窦口疝入中鼻道,持续疝出及增生导致ACP形成。