Obstructive sleep apnea syndrome (OSAS) in children is commonly caused by adenotonsillar hypertrophy. The diagnostic criteria of OSAS in children are not so well delineated as in adults. We report the first case of antral choanal polyp presenting as OSAS in a 10-year-old boy that initially presented to the child psychiatry service for behavior disturbance, enuresis, and daytime somnolence. Overnight electroencephalogram sleep study revealed events consistent with OSAS. Multiple inhalant allergies, chronic maxillary sinusitis, and obstructive adenoid hypertrophy were diagnosed by the allergy and otolaryngology services. The child was scheduled for adenoidectomy when his sleep apnea symptoms persisted following antimicrobial therapy. Examination under anesthesia revealed a normal adenoid bed and a large left antral choanal polyp. Polypectomy was performed as dictated by parental consent. Postoperatively treatment with an intranasal steroid was begun. However, polypoid nasal mucosa recurred in 2 months and a Caldwell-Luc procedure was performed. Subjective reports following surgery indicated improvement in daytime irritability, attention, and mood. A follow-up overnight electroencephalogram sleep study confirmed resolution of OSAS.
"Orvidas et al. (25) noted nasal obstruction (100%), rhinorrhoea (48%), snoring (36%) and mouth breathing (32%) in their patients with ACP. Also, obstructive sleep apnoea and cachexia due to ACP have been reported in the literature (26, 27). "
[Show abstract][Hide abstract] ABSTRACT: Antrochoanal polyps (ACPs) are benign polypoid lesions arising from the maxillary antrum and they extend into the choana. They occur more commonly in children and young adults, and they are almost always unilateral. The etiopathogenesis of ACPs is not clear. Nasal obstruction and nasal drainage are the most common presenting symptoms. The differential diagnosis should include the causes of unilateral nasal obstruction. Nasal endoscopy and computed tomography scans are the main diagnostic techniques, and the treatment of ACPs is always surgical. Functional endoscopic sinus surgery (FESS) and powered instrumentation during FESS for complete removal of ACPs are extremely safe and effective procedures. Physicians should focus on detecting the exact origin and extent of the polyp to prevent recurrence.
[Show abstract][Hide abstract] ABSTRACT: Obstructive sleep apnoea syndrome is a well established entity which has received much attention in the recent past. In children the commonest cause of sleep apnoea is adenotonsillar hypertrophy. We report two cases of antrochoanal polyp in children who presented with symptoms consistent with sleep apnoea. Preoperative polysomnography was performed in these cases which confirmed the diagnosis of sleep apnoea. Under general anaesthesia both children underwent polypectomy with middle meatal antrostomy Post operatively the patients were put on steroid nasal spray for 2 weeks. Repeat polysomnograpy performed four weeks following surgery revealed reversal ot disturbed sleep patterns.
Indian Journal of Otolaryngology and Head & Neck Surgery 01/1998; 50(1):92-4. DOI:10.1007/BF02996787 · 0.05 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: A rare presentation of an antrochoanal polyp is reported. A 14-year-old boy presented with obstructive sleep apnoea and subnormal growth velocity for height and weight over a 1-year period. Examination revealed a post-nasal mass which following removal was confirmed histopathologically as an antrochoanal polyp. Relief of the airway obstruction was promptly followed by catch-up growth and subsequent normal growth velocities. The possible mechanisms underlying the cachexia are explored including the possible association with the obstructive sleep apnoea.
International Journal of Pediatric Otorhinolaryngology 09/2000; 54(2-3):163-6. DOI:10.1016/S0165-5876(00)00353-0 · 1.19 Impact Factor
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