Application analysis of nasal endoscopic resection of antrochoanal polypsvia prelacrimal recess approach in adults
Objective To assess the clinical value of nasal endoscopic resection of antrochoanal polyps(ACP)using the prelacrimal recess approach in adults.Methods Between July 2017 and May 2022,22 patients with ACP at the Department of Oto-rhinolaryngology,Nanjing Drum Tower Hospital were enrolled.All patients underwent nasal endoscopic resection of ACP via the prelacrimal recess approach.Ten cases preserved the natural drainage structure of the middle meatus,while 12 cases had an enlarged ostium of the maxillary sinus.Visual Analogue Scale(VAS),sino-nasal out-come test 22(SNOT-22),nasal endoscopy and sinus CT were com-pared before surgery,1 month and 12 months after surgery.We com-pared preoperative and postoperative(at 1 month and 12 months)re-sults of the VAS,the SNOT-22,nasal endoscopy,and sinus CT scans.Results The VAS and SNOT-22 scores of patients 1 month and 12 months after surgery were significantly lower than those before surgery(P＜0.001),and the VAS and SNOT-22 scores of patients 12 months after surgery were significantly lower than those 1 month after surgery(P＜0.001).At the 12month follow-up,endoscopic results indicated no complications such as nasolacrimal duct damage or nasal adhesions in any patient.CT reexamination before and 12 months after operation showed that the inner wall of the maxillary si-nus cavity was smooth,without inflammation or polyp retention,and no recurrence in 10 patients with the natural drainage of maxillary sinus in the middle nasal canal and 12 patients with combined expansion of maxillary sinus through the middle nasal canal.Conclusion The application of nasal endoscopic resection of antrochoanal polypsvia prelacrimal recess approach can safely and effec-tively remove ACP,with fewer postoperative complications and no recurrence during the follow-up period.In addition,retaining the structure of the natural maxillary sinus drainage in the middle nasal canal can achieve the same curative effect as the combined removal of the uncinate process and opening and expanding the maxillary sinus opening.
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