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Modification of endoscopic medial maxillectomy: a novel approach for inverted papilloma of the maxillary sinus

Published online by Cambridge University Press:  26 January 2015

A Ghosh ,
S Pal ,
A Srivastava  and
S Saha
A Ghosh*
Affiliation:
Department of Otolaryngology, MGM Medical College, Kishanganj, India
S Pal
Affiliation:
Department of Otolaryngology, R G Kar Medical College, Kolkata, India
A Srivastava
Affiliation:
Swastik ENT Centre, Ranchi, India
S Saha
Affiliation:
Department of Otolaryngology, National Medical College, Kolkata, India
*
Address for correspondence: Dr A Ghosh, Hope Nursing Home, A/88 NSB Road (East) PO-Searsole-Rajbari, PS-Raniganj, DT-Burdwan, West Bengal, India E-mail: way2anirban@gmail.com
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Abstract

Objective:

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.

Keywords

PapillomaNasal PolypsMaxillary Sinus

Information

Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 129 , Issue 2 , February 2015 , pp. 159 - 163
Copyright
Copyright © JLO (1984) Limited 2015 

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Footnotes

Presented by Dr A Ghosh at the 66th National Conference of the Association of Otolaryngologists of India, 11 January 2014, Mysore, India, and awarded 2nd prize in the best original paper category at the prestigious PA Shah Junior consultant award session.

References

1Hyams, VJ. Papillomas of the nasal cavity and the paranasal sinuses, a clinicopathologic study of 315 cases. Ann Otol Rhinol Laryngol 1971;80:192–6Google Scholar
2Jameson, MJ, Kountakis, SE. Endoscopic management of extensive inverted papilloma. Am J Rhinol 2005;19:446–51.Google Scholar
3Krouse, JH. Development of a staging system for inverted papilloma. Laryngoscope 2000;110:965–8Google Scholar
4Norris, HJ. Papillary lesions of the nasal cavity and paranasal sinuses. Part II. Inverting papillomas. A study of 29 cases. Laryngoscope 1963;73:1–17Google Scholar
5Vrabec, DP. The inverted Schneiderian papilloma: a clinical and pathological study. Laryngoscope 1975;85:186–220Google Scholar
6Han, JK, Smith, TL, Loehrl, T, Toohill, RJ, Smith, MM. An evolution in the management of sinonasal inverting papilloma. Laryngoscope 2001;111:1395–400Google Scholar
7Krouse, JH. Endoscopic treatment of inverted papilloma: safety and efficacy. Am J Otolaryngol 2001;22:87–99Google Scholar
8Banhiran, W, Casiano, RR. Endoscopic sinus surgery for benign and malignant nasal and sinus neoplasm. Curr Opin Otolaryngol Head Neck Surg 2005;2:113–17Google Scholar
9Batsakis, JG, ed. Squamous cell papillomas of the oral cavity, sinonasal tract and larynx. In: Tumours of the Head and Neck – Clinical and Pathological Considerations, 2nd edn. Baltimore, Williams & Wilkins, 1980;130–43Google Scholar
10Phillips, PP, Gustafson, RO, Facer, GW. The clinical behavior of inverting papilloma of the nose and paranasal sinuses: report of 112 cases and review of the literature. Laryngoscope 1990;100:463–9Google Scholar
11Saha, SN, Ghosh, A, Sen, S, Chandra, S, Biswas, D. Inverted papilloma: a clinico-pathological dilemma with special reference to recurrence and malignant transformation. Indian J Otolaryngol Head Neck Surg 2010;62:354–359Google Scholar
12Lawson, W, Le Benger, J, Som, P, Bernard, PJ, Biller, HF. Inverted papilloma: An analysis of 87 cases. Laryngoscope 1989;99:1117–24Google Scholar
13Wormald, PJ, Ooi, E, van Hasselt, CA, Nair, S. Endoscopic removal of sinonasal inverted papilloma including endoscopic medial maxillectomy. Laryngoscope 2003;113:867–73Google Scholar
14Lawson, W, Biller, HF. Treatment outcomes in the management of inverted papilloma: an analysis of 160 cases. Laryngoscope 2003;113:1548–56Google Scholar
15Pasquini, E, Sciarretta, V, Farneti, G, Modugno, GC, Ceroni, AR. Inverted papilloma: report of 89 cases. Am J Otolaryngol 2004;25:178–85Google Scholar