Origin of polyps and accompanying sinonasal pathologies in antrochoanal polyp patients: analysis of 22 patients

OBJECTIVE: Solitary, benign soft tissue masses originating at the maxillary sinus and extending to the nasopharynx are called antrochoanal polyps (ACP). The aim of the study was to determine the origins of ACP accompanying sinonasal pathologies and the effectiveness of endoscopic sinus surgery in patients with ACP. METHODS: Twenty-two patients (13 men, 9 women; age range: 6-50; average age: 28.3±13.3) who were treated for ACP using endoscopic sinus surgery between January 2014 and September 2017 were included in the study. The patient's age, sex, symptom at presentation to the clinic, sinonasal pathologies accompanying the ACP, and adhesion site of ACP inside the maxillary sinus were retrospectively examined. RESULTS: The most frequently encountered symptom in patients was nasal congestion (95.4%). This was followed by snoring and sleeping with an open mouth (31.8%), nasal discharge (22.7%), headache (18.1%), feeling of a foreign body in the throat (9.1%), and epistaxis (4.5%). When the adhesion site of ACP in the maxillary sinus was checked, it was seen that it was the most frequently located in the medial wall (27.2%), followed by the posterior (18.1%) and lateral wall (13.6%). One patient (4.54%) developed recurrence. CONCLUSION: Although the origin of ACP cannot be detected in the paranasal sinus tomography scan, accompanying sinonasal pathologies should be preoperatively identified. Development of angled endoscopes and angled instruments enabling easy removal of cystic lesions renders endoscopic sinus surgery sufficient for the treatment of ACP.