Objective: To investigate the clinical type, diagnosis and prognosis of endoscopic surgery of choanal polyp (CP).
Methods: Thirty four cases of CP treated between January 1998 to December 2005 were retrospectively reviewed. Pathogenesis, original sites, clinical manifestation, its relationship with paranasal sinuses, methods and effects of endoscopic surgery on CP were analysed.
Results: (1) In this study, 18 cases originated from the cyst or polyp in sinus (among them, 17 from maxillary sinus, 1 from posterior ethmoid sinus). (2) Five cases from nasal fontanelles or sphenoethmoidal recess, mucosa of sphenoidal ostium, accompanied with homolateral empyema or mucosal edema of maxillary sinus or sphenoid sinus. (3) Eleven cases from middle turbinate, uncinate process, olfactory cleft, nasal septum and anterior wall mucosa of ethmoidal sinus with normal adjacent sinus. (4) All cases were treated by complete excision of the CP and open sinus procedures of the affected ones with intranasal endoscopic approach. No recurrence was observed during the follow-up.
Conclusions: (1) We propose to divide the CP into three clinical types: intrasinus, sinus obstruction and simple ones. We also suggest to abide by the operation principal based on clinical types and to select rational methods and extent of operation. (2) Definite diagnosis and clinical type can be obtained by endoscopic examination and CT scan of sinus before operation. (3) Endoscopic surgery is precise and mini-invasive in treatment of CP and complete removal of CP root can effectively reduces the recurrence.