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Recurrences of surgery for antrochoanal polyps in children: A systematic review
- Source :
- International Journal of Pediatric Otorhinolaryngology. 106:26-30
- Publication Year :
- 2018
- Publisher :
- Elsevier BV, 2018.
-
Abstract
- Objectives The main purpose was to evaluate the recurrence rate after surgery for antrochoanal polyps (ACPs) in children; secondly, we have analyzed the rate of recurrence for different types of surgery and the risk factors involved. Methods We performed a systematic review searching PubMed and MEDLINE databases including English-language published studies from June 1989 to October 2017 regarding surgical treatment of ACPs in children. Results We included thirteen studies, eight were retrospective and five prospective, with 285 participants, the mean rate of recurrence after ACPs surgery was 15.0% (95% CI:11.0–20.0). Functional endoscopic sinus surgery (FESS) was the main type of surgery used for primary cases (75.4%) followed by the combined approach i.e. FESS with a transcanine sinusoscopy or mini Caldwell-Luc (14%), the Caldwell-Luc (CWL) (8%) and simple polypectomy (SP) (2.8%). Our analysis has demonstrated a significant reduction of recurrences using the combined approach 0% (95% CI: 0.0–8.0) compared with FESS 17.7% (95% CI: 12.8–23.4) or SP 50% (95% CI:15.7–84.3) (p .05). The analysis of the possible risk factors involved in recurrences are inconclusive. Conclusion Recurrences of ACPs in children are still high. The endoscopic sinus surgery is considered the first choice for primary treatment, whilst the external approach may be a valid option in case of recurrence. It seems that the combined approach could reduce recurrence rates in selected patients that cannot be completely managed with endoscopy.
- Subjects :
- Male
medicine.medical_specialty
Adolescent
Databases, Factual
medicine.medical_treatment
Nasal Surgical Procedures
MEDLINE
Paranasal Sinuse
Antrochoanal polyps
03 medical and health sciences
Nasal Polyps
0302 clinical medicine
Recurrence
Risk Factors
Paranasal Sinuses
medicine
Humans
Nasal polyps
Child
030223 otorhinolaryngology
Children
medicine.diagnostic_test
business.industry
Antrochoanal polyp
Endoscopy
030206 dentistry
General Medicine
Functional endoscopic sinus surgery
medicine.disease
Combined approach
Polypectomy
Surgery
Paranasal sinuses
medicine.anatomical_structure
Otorhinolaryngology
Pediatrics, Perinatology and Child Health
Nasal Surgical Procedure
Female
Nasal Polyp
business
Human
Subjects
Details
- ISSN :
- 01655876
- Volume :
- 106
- Database :
- OpenAIRE
- Journal :
- International Journal of Pediatric Otorhinolaryngology
- Accession number :
- edsair.doi.dedup.....849a5e8d6302988278f9dfdc8fc59636