KBB-Forum 2010 , Cilt 9, Sayı 2

OUR CLINICAL EXPERIENCE IN PATIENTS WITH ISOLATED CHOANAL POLYPS REACHING CHOANA

Dr. Arzu TATLIPINAR, Dr. Tanju GÖKÇEER, Dr. Sema KÖKSAL, Dr. Erkan ESEN
Haydarpaşa Numune Eğitim ve Araştırma Hastanesi, KBB, İstanbul, Türkiye Purpose : To present our experience regarding clinical findings, diagnostic methods, effectiveness of surgical methods and clinical course in patients with choanal polyp who underwent surgery in our clinic.

Methods: Twenty-three patients (8 children, M/F: 3/5; 15 adults M/F: 10/5; mean age 26,7 years, age range 10-74) who underwent surgery for choanal polyp in our clinic were included. Patient files were evaluated retrospectively. Patient history forms, ear nose and throat and endoscopic examination findings , radiologic and operation findings, histopathological evaluation and follow up results were recorded. Nasal pathologies accompanying choanal polyps and sinonasal anatomic variations were also recorded.

Results: Major complaint of the patients at presentation was nasal obstruction (100%). There were 21 antrochoanal polyps, 1 ethmochoanal polyp, 1 sphenochoanal polyp. Septal deviation, sinusitis, and chonca bullosa were present in 66,6%, 42,9% and 14,2% of antrochoanal polyp patients, respectively.

Functional endoscopic sinus surgery (20/21), transcanine sinoscopy (4/21), Caldwell-Luc (3/21), septoplasty ( 3/21) and adenoidectomy (1/21) were used as surgical methods. There were two recurrences in patients who underwent functional endoscopic sinus surgery. For these recurrences functional endoscopic sinus surgery was performed in child patient and Caldwell-Luc was performed for adult patient. No new recurrences were observed in postoperative period of 1 year in child patient and 2,5 years in adult patient.

Conclusion: Septal deviation and sinusitis commonly accompany choanal polyps. Endoscopic sinus surgery can be performed in the treatment of choanal polyps both in child and adult age groups, and is an effective treatment modality. In recurrent cases and in stituations where sinus can not be observed through maxillary sinus antrum, transcanine sinoscopy may be employed to rule out residual tissue. Keywords : Nasal obstruction, choanal polyp, endoscopic sinus surgery