scholarly journals Endoscopic medial maxillectomy for sinonasal inverted papilloma

2018 ◽  
Vol 1 (1) ◽  
pp. 20-24
Author(s):  
Shyam Thapa Chettri ◽  
S Karki ◽  
SP Shah ◽  
BP Sah ◽  
S Manandar ◽  
...  
Keyword(s):  
Recurrence Rate ◽  
Histopathological Examination ◽  
Retrospective Chart Review ◽  
Lateral Wall ◽  
Inverted Papilloma ◽  
Open Approach ◽  
Female Ratio ◽  
Medial Maxillectomy ◽  
The Right

Background: Traditionally, medial maxillectomy was performed through lateral rhinotomy or mid facial degloving approach for inverted papilloma. Endoscopic medial maxillectomy, since reported first in 1992, has advanced tremendously and has been advocated by a number of authors for the fact that it prevents the morbidity of open approach with a similar recurrence rate. We present our experience of endoscopic medial maxillectomy for sinonasal inverted papilloma.Aims and Objective: To highlight the treatment of inverted papilloma through transnasal endoscopic approach.Methods: This study is a retrospective chart review of 18 patients out of 23 patients of which 5 were lost on follow-up with inverted papilloma who were treated during the last 2 years. Preoperative diagnosis was made on histopathological examination and Krouse staging in CT scans of paranasal sinus was used to estimate the extent of the disease. Then, surgical approach was decided. Post-operative follow up was done by performing direct nasal endoscopy. All patients were followed up for a minimum period of 1 year.Results: Among the 18 patients who underwent endoscopic medial maxillectomy, sex (male : female) ratio were 1.25: 1, age ranged from 24 yrs to 69 yrs with average being 41.7 yrs. According to Krouse staging, 2 patients were in Stage I, 9 patients in Stage II and 7 patients in Stage III. The laterality of the lesion was more on the right. The commonest site of attachment was found to be the lateral wall of nose. The average duration of hospital stay was 4 days. The commonest complication was nasal crusting and the recurrence rate was 11.11%.Conclusion: This work confirms the results described in recent literature and further supports transnasal endoscopic surgery to manage inverted papilloma.Journal of BP Koirala Institute of Health Sciences, Vol. 1, No. 1, 2018, Page: 20-24

Frontal Sinus Inverted Papilloma: Surgical Strategy Based on the Site of Attachment

2009 ◽  
Vol 23 (3) ◽  
pp. 337-341 ◽  
Author(s):  
Bit-Na Yoon ◽  
Pete S. Batra ◽  
Martin J. Citardi ◽  
Hwan-Jung Roh
Keyword(s):  
Frontal Sinus ◽  
Cleveland Clinic ◽  
Retrospective Chart Review ◽  
Lateral Wall ◽  
Posterior Wall ◽  
Inverted Papilloma ◽  
Surgical Strategy ◽  
University Hospital ◽  
Additional Patient ◽  
Female Ratio

Background The surgical management of inverted papilloma (IP) involving the frontal sinus (FS) remains a challenge given the narrow confines of the frontal recess and the close proximity to critical structures. The objective of this study was to elucidate a surgical strategy for management of frontal sinus IP based on the site of attachment. Methods A retrospective chart review was performed on 18 patients with FS IP treated at the Pusan National University Hospital and the Cleveland Clinic Foundation between 1998 and 2008. Results The mean age was 53.8 years with a male/female ratio of 13:5. The sites of tumor attachment included the medial wall (MW; six cases), posterior wall (PW; five cases), diffuse (all walls involved; five cases), intersinus septal cell (three cases), lateral wall (two cases), and anterior wall (two cases). IP involvement was unifocal in 10 cases and multifocal in 8 cases. Unifocal IP attached to the MW or PW was managed strictly by endoscopic frontal sinusotomy (EFS) in five of six cases (83%). Multifocal IP required endoscopic modified Lothrop (EML) and/or open approaches (endoscopic frontal trephination [EFT], four, osteoplastic flap [OPF], one) in seven of eight cases (88%). One additional patient with bilateral anterior table involvement required OPF. Four (22%) patients developed recurrences. Two were managed by EML, one was managed by EFS, and one was managed by EFT and EFS. Two patients developed cerebrospinal fluid leaks that were managed endoscopically without untoward effects. All patients were free of disease at the time of last evaluation with a mean follow-up of 36.6 months. Conclusion Frontal sinus IP with MW or PW involvement can generally be managed by standard EFS. Tumors with multifocal involvement often require EML, along with adjunct EFT in selected cases. OPF can be avoided as the primary surgical approach in most patients with sinonasal papilloma of FS.

scholarly journals Inverted Papilloma: Our Experience of Endoscopic Medial Maxillectomy and its Outcome in a Tertiary Care Center, Nepal

2020 ◽  
Vol 9 (2) ◽  
pp. 61-65
Author(s):  
Meenakshi Basnet ◽  
Sanjeev Kumar Thakur ◽  
Bibek Ghimire ◽  
Niraj Nepal
Keyword(s):  
Care Center ◽  
Tertiary Care ◽  
Staging System ◽  
Lateral Wall ◽  
Endoscopic Biopsy ◽  
Inverted Papilloma ◽  
Stage Iii ◽  
Female Ratio ◽  
Medical College ◽  
Medial Maxillectomy

Background: Inverted Papilloma arises from the lateral wall of nose and is common in maxillary sinus. It is locally invasive, can recur and has malignant potential. Endoscopic medial maxillectomy is the preferred choice. Materials and Methods: This prospective study was conducted in the department of Otolaryngology, Nobel Medical College and Teaching Hospital, Biratnagar from June 2015 to June 2018. A total of 26 patients were included in the study, after informed consent and ethical clearance. Staging was done by Krouse method after imaging studies and preoperative endoscopic biopsy was performed. These patients then underwent endoscopic medial maxillectomy. All the data were collected in excel spreadsheet and analyzed in SPSS software. Results: Out of a total of 26 patients, male: female ratio was 1.6:1, with 16 male and 10female. Average age was 40.5 years (25-72years). According to Krouse staging, 2 patients were in Stage I, 7 patients in Stage II and 17 patients in Stage III. IP mostly involved the lateral wall of nose.  Unilateral nasal obstruction was the commonest presenting symptom. The commonest post-operative complication was nasal crusting. Most of the patients were treated with simple endoscopic medial maxillectomy. Conclusion: Inverted Papilloma is common in male in their 4th decade of life with lateral wall of the nose being mostly affected. Most patients were in stage III of Krouse’s staging system. Simple endoscopic medial maxillectomy was the commonest procedure.

Clinical Implications of Carcinoma In Situ in Sinonasal Inverted Papilloma

2019 ◽  
Vol 161 (6) ◽  
pp. 1036-1042 ◽  
Author(s):  
Ivy W. Maina ◽  
Charles C. L. Tong ◽  
Esther Baranov ◽  
Neil N. Patel ◽  
Vasiliki Triantafillou ◽  
...  
Keyword(s):  
Malignant Transformation ◽  
Recurrence Rate ◽  
Carcinoma In Situ ◽  
Inverted Papilloma ◽  
Sinonasal Inverted Papilloma ◽  
Definitive Surgery ◽  
Severe Degree ◽  
Multiple Recurrences

Objective Sinonasal inverted papilloma (IP) is a typically benign sinonasal tumor with a tendency to recur and the potential for malignant transformation. Varying degrees of dysplasia may be present, of which carcinoma in situ (CIS) is most advanced. We hereby describe the biological and clinical behavior of IP with CIS (IPwCIS). Study Design Retrospective cohort. Setting Tertiary academic referral center. Subjects and Methods Patients who underwent surgical resection for IP between 2002 and 2017. Pertinent clinical data were obtained, and all IPwCIS cases were histologically confirmed. Results In total, 37 of 215 cases (17.2%) were identified with IPwCIS. Mean age was 57 years and 86.5% of patients were male. Median follow-up was 82 months, and the recurrence rate was 27%. The maxillary sinus was the most common primary site (37.8%) and 14 tumors (37.8%) demonstrated multifocal attachment, which was associated with recurrence (odds ratio [OR], 9.7; 95% confidence interval [CI], 1.4-112.8; P = .028). IPwCIS was also associated with multiple recurrences (OR, 2.71; 95% CI, 1.246-5.814; P = .021). Most patients were treated with surgery alone (89.1%) and 4 patients received adjuvant radiotherapy (8.1%). Only 1 patient (2.7%) demonstrated malignant transformation after definitive surgery. Conclusions IPwCIS represents the most severe degree of dysplasia prior to malignant transformation and is associated with higher recurrence rate and multifocal involvement but low rate of conversion to invasive carcinoma. The need for adjuvant therapy remains controversial, and further research into the etiology of the disease is warranted.

scholarly journals Lone Atrial Flutter in Children and Adolescents: Is It Really “Lone”?

2020 ◽  
Author(s):  
Jana-K. Dieks ◽  
David Backhoff ◽  
Heike E. Schneider ◽  
Matthias J. Müller ◽  
Ulrich Krause ◽  
...  
Keyword(s):  
Children And Adolescents ◽  
Atrial Flutter ◽  
Clinical Course ◽  
Histopathological Examination ◽  
Electrophysiological Study ◽  
Conduction Block ◽  
Current Application ◽  
Premature Ventricular Contractions ◽  
The Right

Abstract Atrial flutter (AFL) in children and adolescents beyond the neonatal period in the absence of any underlying myocardial disease (“lone AFL”) is rare and data is limited. Our study aims to present clinical and electrophysiological data of presumed “lone AFL” in pediatric patients and discuss the role of endomyocardial biopsy (EMB) and further follow-up. Since July 2005, eight consecutive patients at a median age of 12.7 (range 10.4–16.7) years presenting with presumed “lone AFL” after negative non-invasive diagnostic work-up had electrophysiological study (EPS) and induction of cavotricuspid isthmus (CTI) conduction block by radiofrequency (RF) current application. In 6/8 patients EMB could be taken. Induction of CTI conduction block was achieved in all patients. Histopathological examination of EMB from the right ventricular septum exhibited myocarditis or cardiomyopathy in 4/6 patients, respectively. During follow-up, 4/8 patients had recurrent arrhythmia (AFL n = 2, wide QRS complex tachycardia n = 1, monomorphic premature ventricular contractions n = 1) after the ablation procedure. 3/4 patients with recurrent arrhythmia had pathological EMB results. The remaining patient with recurrent arrhythmia had a negative EMB but was diagnosed with Brugada syndrome during further follow-up. Taking together results of EMB and further clinical course, only 3/8 patients finally turned out to have true “lone AFL”. Our study demonstrates that true “lone AFL” in children and adolescents is rare. EMB and clinical course revealed an underlying cardiac pathology in the majority of the individuals studied. EMB was very helpful in order to timely establish the diagnosis of myocarditis or cardiomyopathy.

scholarly journals Monophasic Epithelial Synovial Sarcoma Accompanied by an Inverted Papilloma in the Sphenoid Sinus

2012 ◽  
Vol 2012 ◽  
pp. 1-3 ◽  
Author(s):  
Xiaohua Jiang ◽  
Qi Huang ◽  
Jianguo Tang ◽  
Matthew R. Hoffman
Keyword(s):  
Synovial Sarcoma ◽  
Sphenoid Sinus ◽  
Inverted Papilloma ◽  
Sinus Surgery ◽  
Nasal Discharge ◽  
Olfactory Sensation ◽  
History Of ◽  
The Right ◽  
Sphenoid Sinuses

A 58-year-old man presented with a six-month history of intermittent blood-stained posterior nasal discharge. Five years ago, he had a three-week episode of fitful light headaches. Nasal ventilation, olfactory sensation, and facial sensation were normal; there were no ophthalmological complaints. Coronal computed tomography (CT) scans revealed soft masses in the bilateral sphenoid sinuses with bone absorption. The patient underwent bilateral functional endoscopic sinus surgery and resection of right nasal papillary masses. Papillary masses and mucosa in both sphenoid sinuses were also removed. The mass in the left sphenoid sinus was diagnosed as two separate entities, one being a primary monophasic epithelial synovial sarcoma and the other an inverted papilloma, while the mass in the right sphenoid sinus was an inverted papilloma. After surgery, the patient underwent radiotherapy and chemotherapy. At the 50-month follow-up visit, there were no signs of recurrence.

scholarly journals Paravertebral Well-Differentiated Liposarcoma with Low-Grade Osteosarcomatous Component: Case Report with 11-Year Follow-Up, Radiological, Pathological, and Genetic Data, and Literature Review

2017 ◽  
Vol 2017 ◽  
pp. 1-6
Author(s):  
Nicolas Macagno ◽  
Stéphane Fuentes ◽  
Gonzague de Pinieux ◽  
André Maues de Paula ◽  
Sébastien Salas ◽  
...  
Keyword(s):  
Histopathological Examination ◽  
Soft Tissue Sarcomas ◽  
Fish Analysis ◽  
Low Grade ◽  
Central Mass ◽  
Divergent Differentiation ◽  
Paravertebral Muscles ◽  
Well Differentiated ◽  
The Right

Despite being one of the most frequent soft-tissue sarcomas, well-differentiated liposarcoma has never been reported near the spine. The authors present the case of a 67-year-old man with progressive history of back pain. Physical examination revealed a mass located within the right paravertebral muscles. MR and CT imaging showed a heavily ossified central mass surrounded by a peripheral fatty component. No connection with the underlying bone was detected on imagery and during surgery. After surgical resection, histopathological examination revealed a tumor harboring combined features of well-differentiated liposarcoma and low-grade osteosarcoma. Tumor cells displayed overexpression of MDM2, CDK4, and P16 by immunohistochemistry and CGH revealed amplification of 12q13-15 as the only genetic imbalance. MDM2 FISH analysis was performed but was inconclusive. The pathological, immunohistochemical, and genetic features, the differential diagnoses, and the therapeutic management of this unusual tumor are discussed. No complementary treatment was performed initially. Following first treatment, two recurrences occurred 6 and 9 years later, both displaying histological features similar to the first occurrence. Radiotherapy was started after the second recurrence. Follow-up shows no evidence of disease 11 years after initial diagnosis. This case was unusual due to the paravertebral location of the tumor and its divergent differentiation.

Is pharyngeal pouch stapling superior to open pharyngeal pouch repair? An analysis of a single institution's series

2016 ◽  
Vol 130 (9) ◽  
pp. 873-877 ◽  
Author(s):  
E Agalato ◽  
J Jose ◽  
R J England
Keyword(s):  
Surgical Procedures ◽  
Symptom Control ◽  
Open Approach ◽  
Pharyngeal Pouch ◽  
Female Ratio ◽  
Open Procedure ◽  
Long Term Follow Up ◽  
Male To Female

AbstractBackground:Endoscopic stapling has become the primary procedure for pharyngeal pouch surgery because it is quick, less invasive and safe, but less is known about long-term outcomes.Method:Medical records were reviewed to compare rates of morbidity, operative failure, symptom control and revision surgery between open and closed procedures.Results:A total of 120 pharyngeal pouch procedures, carried out on 97 patients from 2000 to 2014, were studied. These included 80 endoscopic stapling and 40 open procedures. Twelve patients had complications (15 per cent) and there was one mortality (1.2 per cent) in the endoscopic stapling group. Ten patients (25 per cent) developed complications in the open procedure group, with no mortalities. Symptom recurrence was significantly greater in the endoscopic stapling group (26 per cent) than in the open procedure group (7.5 per cent). Multiple surgical procedures were required for 22 endoscopically stapled patients (32 per cent); none were required in the open procedure group. Although the male-to-female ratio for pharyngeal pouch incidence was 2:1, the ratio for multiple surgical procedures was 10:1.Conclusion:Endoscopic stapling outcomes are not as good as those following an open approach on long-term follow up, and the early advantages are eliminated if pouch excision is avoided.

Primary temporal inverted papilloma with premalignant change

2010 ◽  
Vol 125 (2) ◽  
pp. 206-209 ◽  
Author(s):  
H Zhou ◽  
Z Chen ◽  
H Li ◽  
G Xing
Keyword(s):  
Recurrence Rate ◽  
Radical Resection ◽  
Therapeutic Strategies ◽  
Inverted Papilloma ◽  
Sinonasal Inverted Papilloma ◽  
Sinonasal Papilloma

AbstractObjectives:To explore the pathology, diagnosis, therapeutic strategies and prognosis of primary temporal inverted papilloma.Methods:We present one of the first reported cases of primary temporal inverted papilloma with premalignant change. The available data are reviewed.Results:To the best of our knowledge, only 10 evaluable cases of this tumour have been reported. The recurrence rate is higher for this tumour than for sinonasal inverted papilloma.Conclusion:Primary temporal inverted papilloma is extremely rare, and its diagnosis should be made only following clinical exclusion of sinonasal papilloma. Therapy mainly comprises radical resection of the lesion, and long-term post-operative follow up is mandatory.

scholarly journals Clinical features and outcomes of adrenal schwannoma: a study of 13 cases from a single center

2021 ◽  
Author(s):  
Henghai Huang ◽  
Qijian Ding ◽  
XiaoCao Lin ◽  
DeLin Li ◽  
Jingjing Zeng ◽  
...  
Keyword(s):  
Operative Management ◽  
Pathological Examination ◽  
Computed Tomography Imaging ◽  
Tertiary Referral Hospital ◽  
Female Ratio ◽  
Tomography Imaging ◽  
Male Female Ratio ◽  
The Mean ◽  
The Right

Background: Adrenal schwannomas (AS) are extremely rare neoplasms. This study shares our experience regarding the diagnosis and operative management of AS. Methods: Clinical details, radiologic, laboratory, and pathologic findings as well as follow-up data were analyzed retrospectively for 13 AS patients who accepted surgery at a tertiary referral hospital in China between January 1, 1996, and December 31, 2017. Results: The mean age of the patients at diagnosis was 44.7 ± 13.7 years (range 19–62 years; male: female ratio, 1:1.16), of whom 7 patients had unilateral AS on the right side, and the remaining 6 on the left side. None of the cases were hormonally active. None of the 13 cases were diagnosed as AS by computed tomography imaging before the operation. Among the patients, 10 were asymptomatic. The mean preoperative size was 7.1 ± 3.2 cm (range 1.6–12.6 cm). All patients underwent surgery, with open adrenalectomy in 5 patients and laparoscopy in 8 patients. The mean tumor size on pathologic examination was 6.8 ± 3.0 cm (range 3.0–11.7 cm). The surgical specimens were confirmed by pathological examination. During a median follow-up of 60.8 ± 17.7 months, no patients showed recurrence or metastasis. Conclusion: The preoperative diagnosis of AS remains difficult despite the advances in imaging examinations. After complete resection, the prognosis of AS is excellent.

scholarly journals Calcified Right Ventricular Fibroma in an Adult: A Case Report

2021 ◽  
Author(s):  
Huanhuan Gao ◽  
Shuai Yuan ◽  
Zhiqiang Hu ◽  
Zhelan Zheng ◽  
Shengjun Wu
Keyword(s):  
Right Ventricular ◽  
Histopathological Examination ◽  
Tumor Resection ◽  
Anterior Wall ◽  
Benign Tumors ◽  
Troublesome Symptom ◽  
History Of ◽  
The Right ◽  
Operative Recovery

Background: Cardiac fibromas are rare benign tumors of the heart composed of fibroblasts and collagen. They are common among children and adolescents but are rarely present in adults. Case presentation: We here report the case of a fifty-seven-year-old man who complaining of a 2-year history of chest tightness at rest. Transthoracic echocardiography detected a severe calcified mass protruding outside the right ventricular anterior wall near the apex. The patient was referred for tumor resection. The calcified mass was determined to be a cardiac fibroma with postoperative histopathological examination. The patient experienced an unremarkable post-operative recovery and was discharged 8 days later. Subsequent follow-up has shown complete freedom from his troublesome symptom. Conclusions: Preoperative diagnosis with various imaging modalities and early surgery are the keys to improve prognosis of patients with cardiac fibromas.

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