The surgical management of an antrochoanal polyp
by Vicky S Khattar, Vicky Bachi T

Jaypee’s Video Atlas of Operative Otorhinolaryngology AND Head & Neck Surgery

by Vicky S Khattar, Bachi T Hathiram
About Video

This video demonstrates the removal of an antrochoanal polyp. The polyp may be removed in near-toto by delivering it transorally, or even debulked by a debrider. The middle meatal antrostomy may have to be widened to localize and tackle the stalk of the polyp. The use of angled telescopes is invaluable for this part of the procedure. Occasionally, a canine puncture may have to be performed, with the endoscope inserted through the canine puncture, and the stalk then tackled through the middle meatal antrostomy. The stalk may then be cauterized. This video attempts to demonstrate the common situations that one may encounter while removing antrochoanal polyps. Each polyp presents differently, and thus any or a combination of the maneuvers demonstrated may be employed to tackle this condition. The surgeon must be prepared for any eventuality to tackle this seemingly simple condition, but one which is associated with a very high degree of recurrence if not performed correctly. A mention must be made about the canine puncture technique demonstrated; while it simulates the advantages of the Caldwell Luc procedure, it is minimally invasive and does not alter the mucociliary transport system as in the former. Thus, the advantage of an end-on visualization is present obviating the need for a struggle with angled telescopes and instruments.

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