The antro-choanal polyp is a rather common pathology in children.
Objective: To discuss the diagnostic modalities, the risk factors, the differential diagnoses and treatment options.
Material and methods: This study was performed in an ENT department of a 3rd referal center Fifteen patients, 12 males and 3 females (8 to 16 year old), were treated for an antro-choanal polyp (Killian's polyp) between 1997 and 2007.
Results: All patients presented a nasal obstruction. Other signs of discovery were a rhinorrhea, a maxillary pain or a pharyngeal mass. Two patients presented a recurrence after a surgery in another center Atopy did not seem to be a risk factor. The imaging evaluation showed a tissular process developed in the maxillary sinus and extending through the maxillary ostium, or an accessory ostium, toward the nose. All patients were treated by intranasal endoscopic surgery. The middle meatal antrostomy was systematic, associated with a inferior antrostomy in 3 cases, with an anterior ethmoidectomy in one case and with a vestibular approach (Caldwell-Luc procedure) in 4 cases. Two patients presented a recurrence which necessited a new surgery.
Conclusion: The antro-choanal polyp must be suspected in front of nasal obstruction in children. The imaging evaluation eliminates the main differential diagnoses. The endo-nasal removal seems to be the best procedure.