Background:Primary antrochoanal polyp management is
commonly done via middle meatal antrostomy which has a
significant risk of recurrence. The prelacrimal recess approach is
reported to minimize this risk. Aim: This study aims to compare the
results of prelacrimal recess approach assisted middle meatal
antrostomy with middle meatal antrostomy alone in the
management of primary antrochoanal polyp. Patients and
methods: A randomized prospective Comparative Study was
performed on sixty patients with primary antrochoanal polyps in the
period from October 2020 to June 2022. The patients were
allocated randomly into two groups, group (A) 30 patients were
surgically managed via only endoscopic middle meatal antrostomy,
and group (B) 30 patients were subjected to endoscopic prelacrimal
recess approach assisted middle meatal antrostomy. Postoperative
follow-up was done subjectively and objectively over 6 months.
Results: Age (p=0.4), sex (p=0.6), and lesion side (p=0.8) showed
no statistically significant differences between the study groups,
although mean operative duration was considerably shorter in Group A (25.2 ± 3.5) than Group
B (37.7 ± 4.2) (p>0.001). Regarding the complications, there was no statistically significant
difference between the two study groups regarding occurrence of Nasal obstruction(p=0.3) and
Synechia(p=0.1), while recurrence rate was statistically significantly higher among group A than
group B (p=0.03). Conclusion: Prelacrimal recess approach assisted middle meatal antrostomy
is a unique method for removing antrochoanal polyps to prevent its recurrence with reasonable
operative time and few postoperative problems.