A.R.M, Center of Otolaryngology, Head and Neck Surgery, Assuta Medical Center, Affiliated with Ben-Gurion University of the Negev, Beer Sheva, Israel.
Department of Otolaryngology - Head and Neck Surgery, Soroka University Medical Center and the Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel.
ORL J Otorhinolaryngol Relat Spec. 2022;84(4):336-341. doi: 10.1159/000518279. Epub 2021 Nov 8.
Endoscopic middle meatal antrostomy (EMMA) is considered the standard approach for surgical management of antrochoanal polyps (ACPs). Recently, an endoscopic inferior meatal antrostomy (EIMA) approach for clearing lesions in the maxillary sinus was described. In this study, we compared the long-term outcome of patients with ACP following surgical treatment using one of these 2 approaches (EIMA or EMMA).
The medical charts of all patients treated for ACPs in our institution between January 1, 2009, and July 1, 2020, were reviewed retrospectively. Patients were invited to complete a long-term follow-up assessment.
Thirty-eight patients were included in the study: EIMA was the only procedure performed in 25 patients (66%) and EMMA was the only procedure performed in 7 patients (18%). Both procedures were performed in 6 patients (16%): 2 patients (5%) underwent simultaneous EMMA and EIMA for better access and visualization and 4 patients (10.5%) underwent surgical revision consisting of EIMA secondary to failed EMMA at other institutions. Median follow-up was 44 months (range, 6 months-11 years). No evidence of recurrent ACPs, recirculation, synechiae, nasolacrimal duct injury, or bleeding was observed in any of our patients. Small nonobstructing cysts were observed in 2 patients (8%) following EIMA.
EIMA prevents violation of the ostiomeatal complex. It provides access to the anteroinferior aspect of the maxillary sinus and should be considered as an alternative to EMMA in patients with ACPs.
内镜中鼻道上颌窦造口术（EMMA）被认为是治疗上颌窦后鼻孔息肉（ACP）的标准方法。最近，一种内镜下下鼻道上颌窦造口术（EIMA）用于清除上颌窦病变的方法被描述。在这项研究中，我们比较了使用这两种方法（EIMA 或 EMMA）之一治疗 ACP 后患者的长期结果。
回顾性分析了 2009 年 1 月 1 日至 2020 年 7 月 1 日期间在我院接受 ACP 治疗的所有患者的病历。邀请患者完成长期随访评估。
本研究共纳入 38 例患者：25 例患者（66%）仅行 EIMA，7 例患者（18%）仅行 EMMA。6 例患者（16%）同时行 EMMA 和 EIMA：2 例（5%）为了更好地进入和可视化而同时进行 EMMA 和 EIMA，4 例（10.5%）因在其他机构行 EMMA 失败而进行手术翻修，包括 EIMA。中位随访时间为 44 个月（范围 6 个月-11 年）。我们所有患者均未观察到复发性 ACP、再循环、粘连、鼻泪管损伤或出血。2 例（8%）患者在 EIMA 后观察到小的非阻塞性囊肿。
EIMA 可防止中鼻道复合体的破坏。它提供了进入上颌窦前下象限的通道，对于 ACP 患者，应考虑作为 EMMA 的替代方法。
