Role of Computed Tomography Findings in the Quest of Understanding Origin of Antrochoanal Polyp
Abstract
Aetio pathogenesis of antrochoanal polyp (ACP) remains unclear. Correlation of clinical, computed tomography (CT) and histopathological findings is attempted in this study for understanding of their origin. A retrospective chart and image review of 22 patients having ACP was done for clinical, histopathological and CT findings on affected and non affected side for extent of opacificattion, thickness of alveolar bone (AB) in the region of medial wall and the floor of maxillary sinus. Also, widening of accessory ostium was measured and compared. The mean of average thickness of AB medially on affected side was [30.91/11.27] [mean (mm)/SD)] compared to non affected side [55.60/20.74] p = 0.0001 (p < 0.05). The vertical AB thickness at floor on affected side [34.05/14.69] versus [68.14/35.29] p = 0.0001. Ipsilateral side accessory ostium widening on affected was measuring [91.45/57.00] against [55.32/38.96] p = 0.018. The additional CT findings in present study showed reduction in thickness of AB in the medial part and floor of maxillary sinus region. These findings to our knowledge have not been reported in the literature till date. The reduction in bone thickness of AB substantiates theory of antral cyst in origin of ACP. However, their association with embryonic dental lamellae needs further evaluation.
Keywords
Antrochoanal polyp Computed tomography Alveolar boneNotes
Compliance with Ethical Standards
Conflicts of interest
All authors declares that they have no conflict of interest.
Ethical Approval
All procedures performed in this study involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Approval of IEC taken. (Ref: SDMIEC:0743:2016).
Informed Consent
Written informed consent taken from all the patients.
References
- 1.Towbin R, Dunbar JS, Bove K (1979) Antrochoanal polyps. AJR Am J Roentgenol 132(1):27–31CrossRefGoogle Scholar
- 2.Basak S, Karaman CZ, Akdilli A, Metin KK (1998) Surgical approaches to antrochoanal polyps in children. Int J Pediatr Otorhinolaryngol 46(3):197–205CrossRefGoogle Scholar
- 3.Hong SK, Min YG, Kim CN, Byun SW (2001) Endoscopic removal of the antral portion of antrochoanal polyp by powered instrumentation. Laryngoscope 111(10):1774–1778CrossRefGoogle Scholar
- 4.Freitas MR, Giesta RP, Pinheiro SD, Silva VC (2006) Antrochoanal polyp: a review of sixteen cases. Braz J Otorhinolaryngol 72(6):831–835CrossRefGoogle Scholar
- 5.Salib RJ, Sadek SA, Dutt SN, Pearman K (2000) Antrochoanal polyp presenting with obstructive sleep apnoea and cachexia. Int J Pediatr Otorhinolaryngol 54(2–3):163–166CrossRefGoogle Scholar
- 6.Maldonado M, Martínez A, Alobid I, Mullol J (2004) The antrochoanal polyp. Rhinology 42(4):178–182PubMedGoogle Scholar
- 7.Kahn CE Jr, Carrino JA, Flynn MJ, Peck DJ, Horii SC (2007) DICOM and radiology: past, present, and future. J Am Coll Radiol 4(9):652–657CrossRefGoogle Scholar
- 8.Rudack C, Stoll W, Bachert C (1998) Cytokines in nasal polyposis, acute and chronic sinusitis. Am J Rhinol 12(6):383–388CrossRefGoogle Scholar
- 9.Berg O, Carenfelt C, Silfversward C, Sobin A (1988) Origin of the choanal polyp. Arch Otolaryngol Head Neck Surg 114(11):1270–1271CrossRefGoogle Scholar
- 10.Chen JK, Schloss MD, Azouz ME (1989) Antrochoanal polyps: a 10 year retrospective study in the pediatric population with a review of the literature. J Otolaryngol 18(4):168–172PubMedGoogle Scholar
- 11.Piquet JJ, Chevalier D, Leger GP, Rouquette I, Leconte-Houcke M (1992) Endonasal microsurgery of antro-choanal polyps. Acta Otorhinolaryngol Belg 46(3):267–271PubMedGoogle Scholar
- 12.Berg O, Carenfelt C, Sobn A (1989) On the diagnosis and pathogenesis of intramural maxillary cysts. Acta Otolaryngol 108(5–6):464–468CrossRefGoogle Scholar
- 13.Cook PR, Davis WE, McDonald R, McKinsey JP (1993) Antrochoanal polyposis: a review of 33 cases. Ear Nose Throat J 72(6):401–412CrossRefGoogle Scholar
- 14.Stammberger H, Hawke M (1993) Essentials of functional endoscopic sinus surgery. Mosby, St Louis, pp 103–105Google Scholar
- 15.Pruna X, Ibañez JM, Serres X, Garriga V, Barber I, Vera J (2000) Antrochoanal polyps in children: CT findings and differential diagnosis. Eur Radiol 10(5):849–851CrossRefGoogle Scholar
- 16.Min YG, Chung JW, Shin JS, Chi JG (1995) Histologic structure of antrochoanal polyps. Acta Otolaryngol 115(4):543–547CrossRefGoogle Scholar