Antrochoanal Polyp endoscopic
Balasubramanian M.S. D.L.O.
arises from maxillary antrum. It exists through an
enlarged accessory ostium and enters the nasal cavity. It will
exit through the choanal orifice and present itself in the
This surgery is performed using a nasal
endoscope. The nasal cavity is packed with roller gauze
impregnated with 4% xylocaine mixed with 1 in 10,000
adrenaline. One pack is placed in the inferior meatus, one is
placed in them middle meatus and the third one is placed in the
floor of the nose.
As a first step uncinate process is
removed using a back biting forceps. The uncinate process must
be removed completely. The maxillary sinus ostium is clearly
visualised. In this patient as soon as the uncinate process is
removed pus can be seen streaming out from the infundibulum.
Most probably the polyp was obstructing the drainage of the
The polyp is removed by avulsing it using
a straight Blakesley forceps. A continuous gentle traction is
sufficient to dislodge the polyp. The antral component can be
separately removed using a 45 degree Blakesley
After the procedure the middle meatus is packed
with gelfoam. This pack will prevent undesirable synechiae
developing in the nasal cavity.
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