상악동 후비공 비용의 임상적 고찰： 상악동내 기시부위에 따른 내시경 수술 방법

Background and Objectives: The aims of thid study were to analyze the clinical characteristics of antrochoanal polyps (ACPs) and find proper operative method. Materials and Methods: This is a retrospective review of 48 patients performed ESS and puncture and shaving technique for antrochoanl polyp. Clinical symptoms, correlation with allergy and sinusitis, origion site of ACP, passage site of ACP (natural ostium vs. accessory ostium) , operative technique of antrochoanal polyp according to origin site, recurrence according to operative technique, complications were analyzed. Results: Nasal obstruction was the most common symptom in our study. 61.3% of patients with ACP showed allergy in MAST, nasal cytology and total serum IgE test. 56.3% of ACPs herniated into the nasal cavity through the natural ostium, 41.7% of ACPs herniated through the accessory ostium. All 48 patients underwent ESS, and among of them, 12 patients underwent operation using “puncture and shaving” technique. The ACPs in this study originated from the lateral wall (30.4%), anterior wall (8.8%), posterolateral wall (13%), posteroinferior wall (13%), inferior wall (13%), medial wall (4.4%), superior wall (4.4%) of maxillary antrum in the subgroup of patients who underwent conventional ESS. In the other subgroup of patients who underwent “puncture and shaving” technique, the ACPs originated from the lateral wall (37.5%), anterior wall (37.5%), posterolateral wall (12.5%), posterior wall (12.5%) of maxillary antrum. The recurrence rate following surgery using “puncture and shaving technique” in patients with ACPs was significantly low than the patients who underwent conventinal ESS. Conclusion: The endoscopic approach to the removal of ACPs has proven to be a safe and effective means of managing ACPs. When the ACPs originated from the posterior wall or lateral wall around posteral wall of maxillary antrum, conventional ESS can be a safe and effective means of managing ACPS, but if the ACPs originated from the anterior wall or lateral wall around anterior wall of maxillary antrum, “puncture and shaving” tehnique is needed for complete removal of ACPs. (J Clinical Otolaryngol 2007;18:224–228)