Debride and Conquer: A New Angle in Endoscopic Removal of Antrochoanal Polyps

Abstract

Objective: Antrochoanal Polyps can be problematic to remove fully due to their location and instruments available. Method: Using a combination of paediatric and adult sized instruments, viewed with 30 and 70 degree endoscopes, we could partially remove the polyp through a large middle meatal antrostomy (MMA). Being unable to reach the remaining stalk, despite proceeding to an inferior antrostomy (IA), we realised the need for a more acute-angled instrument. By curving the monopolar Valleylab suction diathermy (MVSD), mimicking the curved microdebrider, we inserted this through our MMA. With an endoscope and a curved ball probe through the IA, we further increased the angle of the MVSD and cauterised the base of the polyp. Results: Clinically the polyp appeared to be fully resected. Conclusion: Consideration must be given to the infraorbital nerve and its relation to the base of the polyp. With this in mind, it is a safe technique.