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DOI 10.3342/ceo.2010.3.2.110
Antrochoanal polyps (ACPs) are benign polypoid lesions arising from the maxillary antrum and they extend into the
choana. They occur more commonly in children and young adults, and they are almost always unilateral. The etiopathogenesis of ACPs is not clear. Nasal obstruction and nasal drainage are the most common presenting symptoms. The differential diagnosis should include the causes of unilateral nasal obstruction. Nasal endoscopy and computed tomography
scans are the main diagnostic techniques, and the treatment of ACPs is always surgical. Functional endoscopic sinus
surgery (FESS) and powered instrumentation during FESS for complete removal of ACPs are extremely safe and effective procedures. Physicians should focus on detecting the exact origin and extent of the polyp to prevent recurrence.
Key Words. Antrochoanal polyp, Diagnosis, Nasal obstruction, Treatment
INTRODUCTION
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HISTOPATHOLOGIC EXAMINATION
ETIOPATHOGENESIS
112 Clinical and Experimental Otorhinolaryngology Vol. 3, No. 2: 110-114, June 2010
DIFFERENTIAL DIAGNOSIS
The differential diagnosis of ACPs should include juvenile
angiofibroma, nasal glioma, meningoencephalocele, inverted
papilloma, mucocele, mucus retention cyst, Tornwalts cyst, grossly enlarged adenoids, lymphoma and nasopharyngeal malignancies
(1-3, 8, 28, 31).
Mucus retention cyst occurs following obstruction of the
mucus-secreting glands within sinuses, and particularly in the
maxillary sinus antrum. It is a mucus-filled epithelial cyst arising
from the walls of the sinus cavity, and it does not extend into
the choana (31). A crescent-shape air rim above the cyst usual-
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(35) used combined endoscopic middle meatal surgery and transcanine sinoscopy to remove the residual tissue of ACPs in the
antrum. Lee and Huang (2) used the transnasal endoscopic
approach for ACPs originating from the inferior and posterior
walls of the maxillary sinus and they used the combined endoscopic and transcanine approach for ACPs originating from the
lateral walls of the maxillary sinus and for the recurrent
patients. They reported the success rate of the transnasal endoscopic approach and the combined endoscopic and transcanine
approach as 76.9% and 100%, respectively.
CONCLUSION
Fig. 5. Gross appearance of an antrochoanal polyp.
CONFLICT OF INTEREST
No potential conflict of interest relevant to this article was reported.
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