Management of Maxillary Sinus Inverted Papilloma via Transnasal Endoscopic Anterior and Medial Maxillectomy

AbstractObjective:To describe modification to endoscopic medial maxillectomy for treating extensive Krouse stage II or III inverted papilloma of the nasal and maxillary sinus.Method:Ten patients with inverted papilloma arising from the nasoantral area underwent diagnostic nasal endoscopy, contrast-enhanced computed tomography scanning of the paranasal sinus and pre-operative biopsy of the nasal mass. They were all managed using endoscopic medial maxillectomy and followed up for seven months to three years without recurrence.Results:Most patients were aged 41–60 years at presentation, and most were male. Presenting symptoms were nasal obstruction, mass in the nasal cavity and epistaxis. In each case, computed tomography imaging showed a mass involving the nasal cavity and maxillary sinus, with bony remodelling. The endoscopic medial maxillectomy approach was modified by making an incision in the pyriform aperture and removing part of the anterolateral wall of the maxilla bone en bloc.Conclusion:Modified endoscopic medial maxillectomy providing full access to the maxillary and ethmoid sinuses is described in detail. This effective, reproducible technique is associated with reduced operative time and morbidity.

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Endoscopic Modified Medial Maxillectomy for Inverted Papilloma of the Maxillary Sinus

Journal of Craniofacial Surgery ◽

10.1097/scs.0000000000007989 ◽

2021 ◽

Vol Publish Ahead of Print ◽

Author(s):

Qinghua Liu ◽

Cuilian Weng ◽

Hao Zheng ◽

Lihua Wu ◽

Shaopeng Huang

Keyword(s):

Maxillary Sinus ◽

Inverted Papilloma ◽

Medial Maxillectomy ◽

Modified Medial Maxillectomy

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Endoscopic Modified Medial Maxillectomy for Resection of an Inverted Papilloma Originating from the Entire Circumference of the Maxillary Sinus

Case Reports in Otolaryngology ◽

10.1155/2015/952923 ◽

2015 ◽

Vol 2015 ◽

pp. 1-6

Author(s):

Kota Wada ◽

Takashi Ishigaki ◽

Yutaro Ida ◽

Yuki Yamada ◽

Sachiko Hosono ◽

...

Keyword(s):

Maxillary Sinus ◽

Surgical Approach ◽

Staging System ◽

Inferior Turbinate ◽

Nasolacrimal Duct ◽

Inverted Papilloma ◽

Sinonasal Inverted Papilloma ◽

Medial Maxillectomy ◽

Magnetic Resonance Imaging Mri ◽

Modified Medial Maxillectomy

For treatment of a sinonasal inverted papilloma (IP), it is essential to have a definite diagnosis, to identify its origin by computed tomography (CT) and magnetic resonance imaging (MRI), and to select the appropriate surgical approach based on the staging system proposed by Krouse. Recently, a new surgical approach named endoscopic modified medial maxillectomy (EMMM) was proposed. This approach can preserve the inferior turbinate and nasolacrimal duct. We successfully treated sinonasal IP with EMMM in a 71-year-old female patient. In this patient, the sinonasal IP originated from the entire circumference of the maxillary sinus. EMMM is not a difficult procedure and provides good visibility of the operative field. Lacrimation and empty nose syndrome do not occur postoperatively as the nasolacrimal duct and inferior turbinate are preserved. EMMM is considered to be a very favorable approach for treatment of sinonasal IP.

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Transnasal endoscopic medial maxillectomy in recurrent maxillary sinus inverted papilloma

Rhinology Journal ◽

10.4193/rhino13.230 ◽

2014 ◽

Vol 52 (4) ◽

pp. 381-385

Author(s):

Reda H. Kamel ◽

Ahmed F. Abdel Fattah ◽

Ayman G. Awad

Keyword(s):

Maxillary Sinus ◽

Endoscopic Resection ◽

Inverted Papilloma ◽

Primary Surgery ◽

High Incidence ◽

Prior Surgery ◽

Medial Maxillectomy ◽

Midfacial Degloving ◽

The Impact

Background: Maxillary sinus inverted papilloma entails medial maxillectomy and is associated with high incidence of recurrence. Objective: To study the impact of prior surgery on recurrence rate after transnasal endoscopic medial maxillectomy. Methodology: Eighteen patients with primary and 33 with recurrent maxillary sinus inverted papilloma underwent transnasal endoscopic medial maxillectomy. Caldwell-Luc operation was the primary surgery in 12 patients, transnasal endoscopic resection in 20, and midfacial degloving technique in one. The follow-up period ranged between 2 to 19.5 years with an average of 8.8 years. Results: Recurrence was detected in 8/51 maxillary sinus inverted papilloma patients (15.7 %), 1/18 of primary cases (5.5 %), 7/33 of recurrent cases (21.2 %); 3/20 of the transnasal endoscopic resection group (15%) and 4/12 of the Caldwell-Luc group (33.3%). Redo transnasal endoscopic medial maxillectomy was followed by a single recurrence in the Caldwell-Luc group (25%), and no recurrence in the other groups. Conclusion: Recurrence is more common in recurrent maxillary sinus inverted papilloma than primary lesions. Recurrent maxillary sinus inverted papilloma after Caldwell-Luc operation has higher incidence of recurrence than after transnasal endoscopic resection.

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Quality of life after endonasal medial maxillectomy in patients with inverted papilloma of the maxillary sinus – resection of the inferior turbinate compared to readaption

10.1055/s-0038-1640894 ◽

2018 ◽

Author(s):

R Rupp ◽

M Traxdorf ◽

M Koch

Keyword(s):

Quality Of Life ◽

Maxillary Sinus ◽

Inferior Turbinate ◽

Inverted Papilloma ◽

Medial Maxillectomy

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Functional endoscopic sinus surgery (FESS) in unilateral sinus disease

Otolaryngologia Polska ◽

10.5604/01.3001.0010.5314 ◽

2017 ◽

Vol 71 (5) ◽

pp. 29-35 ◽

Cited By ~ 2

Author(s):

Daniela Mielcarek-Kuchta ◽

Karolina Simon ◽

Dawid Kondratowicz ◽

Zofia Łukomska ◽

Aleksandra Rybak-Korytowska

Keyword(s):

Maxillary Sinus ◽

Endoscopic Sinus Surgery ◽

Malignant Tumors ◽

Inverted Papilloma ◽

Sinus Surgery ◽

Malignant Degeneration ◽

Sinus Disease ◽

Choanal Polyp ◽

Medial Maxillectomy ◽

Extensive Surgery

Background: Unilateral sinus disease (USD) occurs in 23 % of all cases. It is believed that it is mainly associated with cancer development. Retrospective data from large rhinological centers show that the most common USD is chronic rhinosinusitis (CRS), followed by mycosis, inverted papilloma and finally cancer, but only in a small percent of cases. The aim of the study: The analysis of USD in the group of patients who underwent FESS at the secondary referral center. Material and Method: The retrospective study of patients treated for USD in the Department of Otolaryngology in the Provincial Hospital in Poznan between June 2014 and June 2016. The analysis includes age, sex, the localization of lesions, histopathological and microbiological results, an extension of the surgery and treatment results. Results: Over the analyzed period of time, 415 FESS for chronic sinusitis were performed. In this group, 83 patients underwent surgery for USD. There were 35 women and 48 men.CRS was found in 48 cases, mycosis in nine cases, 12 patients were operated for non-malignant tumors, such as inverted papilloma (9), osteoma (2) and fibrosis tumor(1); seven patients had a choanal polyp and two of them had a foreign body in maxillary sinus – a tooth root lying loose. Four patients were diagnosed with a hypoplastic maxillary sinus and one patient suffered from frontal sinus pyocele. One side endoscopic opening of all sinuses was performed in the group with CRS, endoscopic medial maxillectomy was conducted in patients with inverted papilloma, and an isolated opening of the affected sinus was performed in the cases with mycosis. Conclusions: USD must be always suspected of malignant degeneration until proven otherwise. Endoscopic sinus surgery with the use of angled scope allows for the removal of even very extensive lesions. In our opinion, the extent of operation is determined by the nature of pathology. While extensive surgery is recommended in patients with inverted papilloma, a limited procedure should be performed in those with isolated mycosis.

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