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小儿后鼻孔息肉的内镜治疗:我们的经验。

Endoscopic management of paediatric antrochoanal polyp: our experience.

机构信息

Department of Otorhinolaryngology, Mansoura University, Mansoura, Egypt.

出版信息

Acta Otorhinolaryngol Ital. 2013 Apr;33(2):107-11.

Abstract

Antrochoanal polyp is a benign polypoid lesion arising from the oedematous mucosa of the maxillary sinus and extending through the maxillary ostium into the nose. In children, it constitutes 33% of all nasal polyps. Surgery is the usual treatment for antrochoanal polyps. The primary aim of treatment for antrochoanal polyp is complete removal with total clearance of the maxillary sinus. Herein, we present 36 cases of children with antrochoanal polyps (ACPs). All patients underwent preoperative radiological assessment by CT scan. All patients were subjected to uncinectomy and modified type III maxillary sinusotomy of the maxillary ostium for removal of the ACPs. Modified type III maxillary sinusotomy was performed by dilatation of the ostium of the maxillary sinus posteriorly, inferiorly and anteriorly. The most frequent presenting complaint was unilateral nasal obstruction, followed by rhinorrhoea. In 28 children, the polyps passed through the main ostium, while in 5 patients the polyp passed through the accessory ostium. In 3 children, the origin could not assessed. The antral portion of the ACP was cystic in 3 patients and polypoidal in 33 cases. Recurrence was reported in 4 patients (11.1%) that were subjected to revision endoscopic sinus surgery. The follow-up period ranged from 12 months to 5 years with a mean of 3.5 years.

摘要

上颌窦后鼻孔息肉是一种起源于上颌窦水肿黏膜并通过上颌窦口延伸至鼻腔的良性息肉样病变。在儿童中,它占所有鼻息肉的 33%。手术是治疗上颌窦后鼻孔息肉的常用方法。治疗上颌窦后鼻孔息肉的主要目的是通过完全清除上颌窦来彻底切除。在此,我们报告了 36 例儿童上颌窦后鼻孔息肉(ACPs)患者。所有患者均在术前通过 CT 扫描进行影像学评估。所有患者均接受了钩突切除术和改良 III 型上颌窦口切开术,以切除 ACPs。改良 III 型上颌窦口切开术通过向后、向下和向前扩大上颌窦口来进行。最常见的主诉是单侧鼻塞,其次是流涕。在 28 例儿童中,息肉穿过主窦口,而在 5 例患者中,息肉穿过副窦口。在 3 例儿童中,无法评估息肉的起源。3 例 ACP 的窦腔部分呈囊性,33 例呈息肉样。4 例患者(11.1%)复发,接受了再次内镜鼻窦手术。随访时间为 12 个月至 5 年,平均 3.5 年。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/99c5/3665376/5ab158926733/0392-100X-33-107-g001.jpg

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