The Role of Powered Instrumentation in the Removal of Antrochoanal Polyps: A 10-Year Review

Role of powered instrumentation in antrochoanal polyps
Vol. 4 No. 2 : 2009 (108-114)

Mohd Tahir J Mohd Tahir J
Gendeh BS Gendeh BS
Mohd Razif MY Mohd Razif MY

Abstract
Antrochoanal polyps are rare lesions. We report a series of 40 consecutive cases of antrochoanal polyps treated in our tertiary centre over a period of ten years between May 1998 and April 2008. The median age of the patients was 37 years. The most common clinical symptom was nasal obstruction (92.5%) followed by rhinorrhoea (45%), postnasal drip (35%) and snoring (22.5 %). The median period of follow-up of these patients was 30 months. Various surgical approaches were used; the commonest was powered endoscopic polypectomy and middle meatal antrostomy in 28 patients (70%), followed by endoscopic polypectomy and middle meatal antrostomy in seven patients (17.5%). Five patients (12.5%) underwent powered endoscopic polypectomy without middle meatal antrostomy. In addition, two patients had septoplasty and one had a frontal sinustomy. There were six patients (15%) who had combined sublabial antrostomy. No major complications occurred; four patients relapsed; three patients had initial operation performed elsewhere and one patient developed recurrence after the first surgery. The median hospitalization period was three days. We conclude that, the use of powered instrumentation in the removal of antrochoanal polyps is safe, effective and associated with minimal morbidity.
Keywords : antrochoanal polyps, endoscopic polypectomy, middle meatal antrostomy, powered instrumentation, transcanine antroscopy,
Abstrak
Polip antrokoanal merupakan ketumbuhan benigna yang jarang berlaku. Kami mela­porkan 40 kes polip antrokoanal yang dirawat di Pusat Perubatan UKM selama sepu­luh tahun diantara Mei 1998 hingga April 2008. Median umur pesakit yang terlibat adalah 37 tahun. Simptom klinikal yang sering menjadi masalah utama adalah hidung tersumbat (92.5%), diikuti oleh hidung berair (45%), lelehan belakang hidung (35%) dan berdengkur (22.5%). Median tempoh rawatan susulan adalah 30 bulan. Pelbagai pendekatan pembedahan telah digunakan; pembedahan yang paling kerap dilakukan adalah polipektomi endoskopi dengan peralatan berkuasa elektrik dan antrostomi  meatus tengah pada 28 pesakit (70%), diikuti oleh polipektomi endoskopi dan an­trostomi meatus tengah pada tujuh pesakit (17.5%) dengan peralatan konvensional. Lima pesakit (12.5%) menjalani polipektomi endoskopi dengan peralatan berkuasa elektrik tanpa antrostomi meatus tengah. Selain itu, dua pesakit menjalani septoplasti dan seorang pesakit menjalani sinustomi frontal. Terdapat enam pesakit (15%) men­jalani pembedahan kombinasi antrostomi sublabial. Tiada komplikasi besar berlaku ; empat pesakit mengalami penyakit berulang ; tiga pesakit menjalani pembedahan di tempat lain dan seorang daripadanya mengalami penyakit berulang selepas pembe­dahan pertama. Median tempoh penempatan di dalam wad adalah tiga hari. Kami me­rumuskan bahawa penggunaan peralatan berkuasa elektrik dalam rawatan antro­koanal polip adalah selamat, efektif dengan morbidity yang minima.
Kata Kunci : antroskopi transkanin, antrostomi meatus tengah, peralatan berkuasa elektrik, polip antrokoanal, polipektomi endoskopi,

Correspondance Address
Prof Dato’ Dr Balwant Singh Gendeh, Department of Othorhinolaryngology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Bandar Tun Razak, 56000 Cheras, Kuala Lumpur. Email: bsgendeh@gmail.com