Our Summary

This research looked at two different surgical methods for treating a type of nasal polyp (a non-cancerous growth in the nose) in children. The first method, called functional endoscopic sinus surgery (FESS), is the usual treatment. The second method combined FESS with another procedure called the Caldwell-Luc procedure.

The study involved 27 children who had recurring nasal polyps, and it looked back at their treatment from 2010 to 2018. The researchers found that the polyps came back in about 73% of the children who had only the FESS procedure. In contrast, the polyps only came back in about 13% of the children who had the combined FESS and Caldwell-Luc procedure.

The study didn’t report any complications from either surgery. The researchers concluded that figuring out where the polyp starts and improving the ventilation in the maxillary sinus (the largest of the sinuses in the face) can help prevent the polyp from coming back. While FESS is still considered the best treatment for this type of nasal polyp, combining it with the Caldwell-Luc procedure might be a good option for removing the polyp completely through two openings, especially in cases where the polyp has come back after the first surgery.

FAQs

  1. What is the difference between functional endoscopic sinus surgery and the combined approach for treating antrochoanal polyp in children?
  2. What was the recurrence rate of antrochoanal polyp after functional endoscopic sinus surgery alone compared to the combined approach?
  3. How can the recurrence of an antrochoanal polyp be prevented after surgery?

Doctor’s Tip

A helpful tip a doctor might tell a patient about nasal polyp removal is to ensure proper ventilation of the affected sinuses by widening the ostium during surgery. This can help prevent recurrence of the polyps. In cases of revision surgery, a combined approach such as functional endoscopic sinus surgery plus the Caldwell-Luc procedure may be necessary to ensure complete removal of the polyp. It is important to follow post-operative care instructions and attend follow-up appointments to monitor for any complications.

Suitable For

Patients who are typically recommended nasal polyp removal are those who have recurrent antrochoanal polyps, especially pediatric patients. In cases where functional endoscopic sinus surgery alone has a high recurrence rate, a combined approach involving functional endoscopic sinus surgery plus the Caldwell-Luc procedure may be recommended to reduce the risk of recurrence. This combined approach can ensure complete removal of the polyp through both openings, leading to better treatment outcomes.

Timeline

  • Patient is diagnosed with antrochoanal polyp, typically experiencing symptoms such as nasal congestion, facial pain, and sinus pressure.
  • Patient undergoes functional endoscopic sinus surgery (FESS) alone, with a high recurrence rate of 72.9% reported.
  • Patient may experience recurrence of the polyp and continued symptoms.
  • Patient undergoes combined approach surgery (FESS plus Caldwell-Luc procedure) to address recurrent antrochoanal polyp.
  • Recurrence rate after combined approach surgery is significantly lower at 12.5%.
  • Patient experiences relief from symptoms and improved sinus ventilation after successful removal of the polyp.
  • Patient may not experience any complications during surgery or follow-up.
  • Correct identification of the polyp origin and widening of the ostium are key factors in preventing future recurrences.
  • FESS remains the standard treatment for antrochoanal polyp, with the combined approach recommended for revision surgeries.

What to Ask Your Doctor

  1. What is the likelihood of the nasal polyps recurring after functional endoscopic sinus surgery alone versus a combined approach (functional endoscopic sinus surgery plus Caldwell-Luc procedure)?
  2. What are the potential risks and complications associated with nasal polyp removal surgery?
  3. What is the recovery process like after nasal polyp removal surgery?
  4. Are there any alternative treatment options for nasal polyps besides surgery?
  5. How long will it take for me to see improvement in my symptoms after nasal polyp removal surgery?
  6. Will I need to follow any specific post-operative care instructions or take any medications after the surgery?
  7. How frequently will I need follow-up appointments after nasal polyp removal surgery?
  8. What can I do to prevent nasal polyps from recurring in the future?
  9. Are there any lifestyle changes or dietary adjustments that can help manage nasal polyps?
  10. Are there any specific symptoms or signs I should watch out for that may indicate a complication after nasal polyp removal surgery?

Reference

Authors: Mantilla E, Villamor P, De La Torre C, Álvarez-Neri H. Journal: J Laryngol Otol. 2019 Jul;133(7):627-631. doi: 10.1017/S0022215119000938. Epub 2019 May 9. PMID: 31070118