Hüseyin ALTUN, Ayşenur MERİÇ, Murat CERAN, Orhan GEDİKLİ

Koanal polipli olgularda endoskopik yaklaşım

Amaç: Koanal polip nedeniyle endoskopik yaklaşımla tedavi edilen olgular değerlendirildi.Hastalar ve Yöntemler: Çalışmaya koanal polip nedeniyle endoskopik yaklaşımla ameliyat edilen 12 hasta alındı. Hastalar ameliyat öncesinde endoskopik nazal ve nazofarengeal muayene, paranazal sinüs bilgisayarlı tomografisi ile değerlendirildi; kanda total IgE ve spesifik IgE düzeylerine bakıldı ve deri testi yapıldı. Yedi olguda %58 antroakoanal polip, iki olguda %17 etmokoanal polip, iki olguda sfenokoanal polip, bir olguda %8 konkakoanal polip vardı. Etmokoanal polipli olgularda anterior ethmoidektomi uygulandı. Sfenokoanal polipli olgularda intranazal polipektomi yapıldı. Endoskopik olarak polipin köken aldığı mukoza tam belirlenemeyen antroakoanal polipli iki olguda transkanin sinoskopi yapıldı. Bütün olgularda polipin köken aldığı mukoza temizlendi. Kontrol incelemeleri birinci ve altıncı aylarda ve birinci yılda yapıldı. Bulgular: Hastalarda en sık rastlanan semptomlar burun tıkanıklığı %70 ve burun akıntısı %52 idi. Alerji testlerinde antroakoanal polipli iki olguda alerji saptandı. Komplikasyon olarak iki olguda hafif kanama görüldü. Bir yıl izlem sonunda hiçbir olguda nüks saptanmadı. Sonuç: Koanal polipli olgularda endoskopik yaklaşım tüm yaş gruplarında uygulanabilir ve morbidite oranı düşük bir tedavi yöntemidir

Anahtar Kelimeler:

Endoskopi, burun tıkanıklığı/etyoloji, nazal polip/radyografi/cerrahi

Endoscopic approach in patients with choanal polyps

Objectives: We evaluated the results of endoscopic treatment for choanal polyps. Patients and Methods: Twelve patients 5 females, 7 males; mean age 25 years; range 10 to 49 years underwent endoscopic surgery for choanal polyps. Preoperatively, all the patients were evaluated with endoscopic nasal cavity and nasopharyngeal examination and computed tomography of the paranasal sinuses. In addition, serum total and specific IgE levels were measured and prick test was performed. There were seven antrochoanal 58% , two ethmochoanal 17% , two sphenochoanal polyps, and one patient 8% had a chonchachoanal polyp. Anterior ethmoidectomy and intranasal polypectomy were performed for ethmochoanal and sphenochoanal polyps, respectively. Two patients in whom antral part of the mucosa could not be clearly determined underwent transcanine sinoscopy. In all the patients, the mucosa giving rise to polyps was removed. Evaluations were made at one and six months and at the end of a year. Results: The most common symptoms were nasal obstruction 70% and nasal discharge 52% . Allergic tests were positive in two patients with antrochoanal polyps. The only complication was mild bleeding in two patients. No recurrences were encountered within a year follow-up. Conclusion: Endoscopic approach for choanal polyps can be applied at all ages and it is associated with low morbidity.

Keywords:

Endoscopy, nasal obstruction/etiology, nasal polyps/radiography/surgery,

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