Antrochoanal polyps are infrequent benign nasal masses, its a unilateral. This was a prospective study in which the cases were subjected to surgery and were followed. In 1891, zuckerkandl described the case of a polyp arising from the maxillary sinus and coming out through a wide accessory ostium. Nasal polyps are usually classified into antrochoanal polyps and ethmoidal polyps. Antrochoanal polyps arise from the maxillary sinuses and are the much less common. Antrochoanal polyp article about antrochoanal polyp by. The patient remained asymptomatic and diseasefree at followup 6 months later. The following medical conditions are some of the possible causes of antrochoanal polyp. Both the antrochoanal polyp and nasal polyps are myxoid and both are lined by ciliated pseudostratified columnar epithelium, the characteristic mucosa of nasal passages and paranasal chambers. Acps are almost always unilateral, although bilateral acps have been reported in literature 5, 6. Due to the narrow pedicle, vascular compromise with secondary. Antrochoanal polyps acp are also known as killian polyps after gustav killian, the doctor who stressed this special type of polyp from the maxillary antrum to choana in 1906 1.
Radiological examination is necessary to differentiate between these two types. So we tried to remove the polyp en block with minimal bleeding. Despite maxillary sinus approach to the polyp origin, postoperative recurrence is a possibility. Stammberger found that antrochoanal polyps left the sinus through an accessory ostium in 70% of the cases 2. An antrochoanal polyp originates in the middle meatus.
Antrochoanal polyp displacing the uvula and the soft palate. Berg o, carenfelt c, silversward c, sobin a1, 1988. An adult male patient with right side antrochoanal polyp he undrewent endoscopic sinus surgery. Antrochoanal polyp in pediatric age group sciencedirect. Antrochoanal polyp was described by professor gustav killian, in 1906 1 antrochoanal polyp acp is a benign lesion 2. Antrochoanal polyps typically appear as smooth, gray or bluish intranasal masses that arise from the ipsilateral maxillary sinus. However, unlike other polyps, they usually have a narrow stalk arising from the maxillary sinus 5,7. Antrochoanal polyp was described by professor gustav. Antrochoanal definition of antrochoanal by medical dictionary. The antrochoanal polyp acp is a unilateral, solitary, pear shaped mass with a cystic. Incomplete excision of antrochoanal polyp almost always leads to recurrence.
An antral cyst or a cystic rudiment, usually attached to the inferolateral aspect of the sinus wall, was disclosed in 15 patients with this condition. Role of computed tomography findings in the quest of understanding origin of antrochoanal polyp. Removal of antrochoanal polyp by shaver video a a a. This video depicts an endoscopic view of an antrochoanal polyp arising from the maxillary sinus. Antroscopy revealed the antral be cytic in 100% of the cases. The origin of choanal polyps was the maxillary antrum in 32 patients. Grossly the antrochoanal polyp is a large, solitary, graywhite, smooth polyp with a stalk of variable length. Maxillary antrum is the most common site of origin of choanal polyps. Jun 30, 2010 antrochoanal polyps acps are benign polypoid lesions arising from the maxillary antrum and they extend into the choana. Site of origin arise from the mucosa of maxillary antrum near its accessory ostium, comes out of it, and grows in the choana and nasal cavity thus, it has 3 parts. There are likely to be other possible causes, so ask your doctor about your symptoms. Conclusion the correct identification of the origin of the antrochoanal polyp and an adequate returning of maxillary ventilation by.
In this video, we are going to see about antrochoanal polyp. The combined external and endonasal approach was the one most used. Professor gustav killian, from freiburg, in his paper the origin of choanal. Ethmoidal polyps arise from the ethmoid sinuses and extend through the middle meatus into the nasal cavity. Contiguous axial or coronal magnetic resonance and ct images help clearly differentiate the rare sphenochoanal polyp from the more common antrochoanal polyp. Pathologically, antrochoanal polyps are identical to other inflammatory polyps. Antrochoanal polyp acp or killian polyp is a benign nonatopic lesion of the. Antrochoanal polyp validating its origin and management by endonasal endoscopic sinus surgery eess anuj kaushal, 1 lakshmi vaid, 1 and p. They pass to the nasopharynx through the sinus ostium and posterior nasal cavity, enlarging the latter two. The patient usually presents with unilateral nasal obstruction.
We report on a series of 33 consecutive cases of antrochoanal polyp acp treated by endoscopic sinus surgery over a fiveyear period. An antrochoanal polyp, or killians polyp is a benign solitary polypoid lesion that affects. Antrochoanal or sphenochoanal polyps refer to polyp growths that originate in the maxillary sinuses. Antrochoanal polyps have been known about for some time. The occurrence of choanal polyps is equally frequent in both males and females and these are most prevalent in teenagers and in young. Antrochoanal polyp was an affection that prevailed among children and young adults. Antrochoanal polyps usually arise in the maxillary sinus and extend into the nasopharynx and represent only 46% of all nasal polyps. Giant antrochoanal polyp presenting as oropharyngeal mass. The antrochoanal polyp, a benign solitary polypoid lesion, usually arises in a maxillary sinus, opacifying and enlarging the sinus cavity without bone destruction. It usually stems from the posterolateral wall of the maxillary. Oct 14, 2011 this video depicts an endoscopic view of an antrochoanal polyp arising from the maxillary sinus. It arises from the antrum of the maxillary sinus and passes through the sinus ostium into the nasal cavity, choana and goes downwards into the nasopharynx.
Similar, less common, polyps can arise in the sphenoid sinus extending into the nasopharynx. Antrochoanal polyp definition of antrochoanal polyp by. Killian described this disease in detail in 1906 1. A solid polypoid lesion seen in adolescent males, which arises in the maxillary antrum but typically presents as a nasal cavity mass, secondarily involving the nasal cavity as it extends through the ostium via a long pedicle. The surgery performed was an endoscopic endonasal sinus surgery preceded and followed by transcanne. To study the origin of the choanal polyp, the maxillary sinus was surgically explored using a preservative technique. Despite approaching the polyp origin in the maxillary sinus, there is a possibility of postoperative recurrence. Discussion macroscopically, the antrochoanal polyp is usually com posed of a cystic part filling the maxillary sinus and a solid.
May 01, 2003 this case is an interesting example of a unilateral antrochoanal polyp that resulted in an anterior and superior displacement of the uvula and soft palate. Antrochoanal polyp validating its origin and management by. Histologically, the polyp is lined by respiratory epithelium with increased inflammatory infiltrate. Antrochoanal polyp validating its origin and management.
It has a characteristic dumbell shape originating from the mucosa of the maxillary sinus, herinates through the accessory ostium 3, into the middle meatus and, thereafter, protruding posteriorly to the choana figure 1 and nasopharynx figure 2. It presents in a similar manner to the more common antrochoanal polyp. Adhesion site of the antrochoanal polyp in the maxillary sinus the origin n % medial 6 27. Antrochoanal polyps acp are solitary sinonasal polyps that arise within the maxillary sinus. All but one patient was treated by endoscopic sinus surgery al. An antrochoanal polyp acp is a solitary polyp that arises within the maxillary sinus but passes to the nasopharynx through the sinus ostium and posterior nasal cavity, the mri signal characteristics of this case are typical. These masses can present with facial pain, pressure, sinusitis, or nasal obstruction. Aug 01, 2000 sphenochoanal polyp is a rare entity which originates in the sphenoid sinus cavity and extends into the choana via the ostium. Polyp is edematous mucosa due to repeated inflammation which is protruded from nasal sinus labyrinth. The combined external and endonasal approach was the most used surgical technique.
Apr 08, 2011 removal by combined approachcaldwel luc and fess large antrochoanal polyp extending upto oropharynx fess and caldwel luc approach antrochoanal polyps acp are non allergic benign polyp, which arises from the maxillary sinus, go through its ostium and extends all the way to the ipsilateral choana. Physicians should focus on detecting the exact origin and extent of the polyp to prevent recurrence. Antrochoanal polyp synonyms, antrochoanal polyp antonyms. Other sites of origin may be the sphenoid, ethmoid, rarely septum, and inferior turbinate. Antrochoanal polyp is a benign lesion originating from the mucosa of the maxillary sinus, growing through the accessory ostium into the middle meatus and, thereafter, protruding posteriorly to the choana and nasopharynx. Antrochoanal polyp, which is also known as killians polyp is a benign solitary lesion with a mucin density. Antrochoanal polyp article about antrochoanal polyp by the. Acps usually have two components and these are the cystic and solid polypoid parts 14. The antrochoanal polyp, a benign solitary polypoid lesion, usually originates in a maxillary sinus, filling and enlarging the sinus cavity with no bone destruction. Nasal mass mimicking antrochoanal polyp bmj case reports. The socalled antrochoanal polyp, rising from the antral mucosa, has appeared to be clinically different in character from the usual nasal polyp although grossly similar in appearance. Origin of the choanal polyp jama otolaryngologyhead. Anesthetic management of patients with large antrochoanal polyps. Myers, d obstruction of the nasopharynx secondary to choanal polyp of antral origin.
Pdf antrochoanal polyps acp are benign lesions that arise from the mucosa of the maxillary. Antrochoanal definition of antrochoanal by medical. The antrochoanal polyp or killian polyp is an infrequent, benign lesion of maxillary origin 90%. Choanal polyp of sphenoidal origin, european archives of oto. Feb 06, 2017 the main challenge in this case was that the patient was claustrophobic and was afraid of the nasal packs. Sinonasal pathologies accompanying antrochoanal polyp sinonasal pathologies n %.
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