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后鼻孔息肉分析

Analysis of choanal polyps.

作者信息

Kizil Yusuf, Aydil Utku, Ceylan Alper, Uslu Sabri, Baştürk Vildan, İleri Fikret

机构信息

From the Department of Otorhinolaryngology Head & Neck Surgery, Gazi University School of Medicine, Ankara, Turkey.

出版信息

J Craniofac Surg. 2014 May;25(3):1082-4. doi: 10.1097/SCS.0000000000000543.

Abstract

Choanal polyps (CPs) are unilateral benign masses usually originating from paranasal sinuses. Maxillary, ethmoid, and sphenoid sinuses are involved in order of decreasing frequency. In this study, the medical records of patients operated on with a clinical diagnosis of CP between 1998 and 2011 were reviewed. A total of 98 patients with a mean age 24.3 years were analyzed. Histopathologic diagnoses were CP in 94 patients and inverted papilloma in 4 patients. The sites of origin were maxillary sinus in 89 patients (90.8%), sphenoid sinus in 6 patients (6.1%), bulla ethmoidalis, inferior concha, and uncinate process in 1 patient each (1.0%). The most common symptoms were nasal obstruction (98.0%) and postnasal drip (30.6%). The surgical approaches were endoscopic sinus surgery in 63 patients (62.4%) unilaterally and in 12 patients (11.9%) bilaterally and unilateral endoscopic sinus surgery with mini Caldwell in 26 patients (25.7%). All 3 recurrences were in pediatric patients, and the recurrence rates among pediatric patients and overall were 7.7% and 3.1%, respectively. Endoscopic sinus surgery is an effective surgical procedure for treatment of CP; however, addition of a mini-Caldwell approach is safe for antrochoanal polyp resection if the endonasal technique fails. Histopathologic examination is mandatory because inverted papillomas may present as CPs.

摘要

后鼻孔息肉(CPs)是通常起源于鼻窦的单侧良性肿物。上颌窦、筛窦和蝶窦受累的频率依次降低。在本研究中,回顾了1998年至2011年间临床诊断为CP并接受手术治疗的患者的病历。共分析了98例平均年龄为24.3岁的患者。组织病理学诊断为CP的有94例,内翻性乳头状瘤4例。起源部位为上颌窦89例(90.8%),蝶窦6例(6.1%),筛泡、下鼻甲和钩突各1例(1.0%)。最常见的症状是鼻塞(98.0%)和鼻后滴漏(30.6%)。手术方式为单侧内镜鼻窦手术63例(62.4%)、双侧内镜鼻窦手术12例(11.9%)以及单侧内镜鼻窦手术联合迷你柯氏位手术26例(25.7%)。所有3例复发均发生在儿童患者中,儿童患者和总体的复发率分别为7.7%和3.1%。内镜鼻窦手术是治疗CP的有效手术方法;然而,如果鼻内技术失败,增加迷你柯氏位手术对于切除上颌窦后鼻孔息肉是安全的。组织病理学检查是必需的,因为内翻性乳头状瘤可能表现为CP。

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