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小儿复发性上颌窦后鼻孔息肉的联合治疗方法:27例儿童的单中心病例系列研究

Combined approach for paediatric recurrent antrochoanal polyp: a single-centre case series of 27 children.

作者信息

Mantilla E, Villamor P, De La Torre C, Álvarez-Neri H

机构信息

Department of Paediatric Otolaryngology, Hospital Infantil de México Federico Gómez, Mexico City, Mexico.

出版信息

J Laryngol Otol. 2019 Jul;133(7):627-631. doi: 10.1017/S0022215119000938. Epub 2019 May 9.

Abstract

OBJECTIVE

To compare functional endoscopic sinus surgery with a combined approach (functional endoscopic sinus surgery plus Caldwell-Luc procedure) for the treatment of paediatric antrochoanal polyp, in terms of antrochoanal polyp recurrence and safety.

METHOD

This retrospective case series comprises 27 paediatric patients with recurrent antrochoanal polyp, treated from January 2010 to January 2018.

RESULTS

The average age of the patients at the time of diagnosis was 10.4 ± 2.49 years. The recurrence rate after functional endoscopic sinus surgery alone was 72.9 per cent, compared with 12.5 per cent after functional endoscopic sinus surgery plus the Caldwell-Luc procedure (p < 0.00001). No complications were reported during surgery or follow up.

CONCLUSION

The correct identification of the origin of the antrochoanal polyp and an adequate returning of maxillary ventilation by widening the ostium can prevent recurrences. Although functional endoscopic sinus surgery continues to be the 'gold standard' for antrochoanal polyp treatment, in cases of revision surgery, a combined approach could ensure the complete removal of the polyp through the two openings.

摘要

目的

比较功能性鼻内镜鼻窦手术与联合手术(功能性鼻内镜鼻窦手术加柯-陆氏手术)治疗儿童上颌窦后鼻孔息肉的息肉复发情况及安全性。

方法

该回顾性病例系列研究纳入了2010年1月至2018年1月期间治疗的27例复发性上颌窦后鼻孔息肉患儿。

结果

诊断时患者的平均年龄为10.4±2.49岁。单纯功能性鼻内镜鼻窦手术后的复发率为72.9%,而功能性鼻内镜鼻窦手术加柯-陆氏手术后的复发率为12.5%(p<0.00001)。手术期间及随访期间均未报告并发症。

结论

正确识别上颌窦后鼻孔息肉的起源并通过扩大开口充分恢复上颌窦通气可预防复发。虽然功能性鼻内镜鼻窦手术仍是治疗上颌窦后鼻孔息肉的“金标准”,但在翻修手术中,联合手术可确保通过两个开口完全切除息肉。

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