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Updated: Jul 17, 2026
Endoscopic Endonasal Trans-sphenoidal Approach: Minimally Invasive Surgery for Pituitary Adenomas
Published on: January 17, 2018
[Endonasal endoscopic approach in the treatment of sino-nasal inverted papillomas]
J Percodani1, X Rose, S Vergez
1Praticien Hospitalier, CHU Rangueil-Larrey, 24, chemin de Pouvourville TSA 300 30, 31059 Toulouse Cedex 9, France. percodani.j@chu-toulouse.fr
Introduction:
Sino-nasal inverted papilloma is a rare benign tumor of the nasal fossa and the paranasal sinuses for which the successful surgical treatment by an endonasal approach has been corroborated in the literature. Nevertheless, the authors aim in this study to evaluate the advantages and the limits of this approach, to analyse its failures and its recurrences, and to define the indications for using it with the external or dissimulated approach.
Material And Methods:
42 patients presenting with a sino-nasal inverted papilloma and treated surgically over a ten year period were included in this retrospective study. The operative technique was chosen as a function of the endonasal and radiological examination results (CT scan and MRI). Follow-up was over one year for all patients.
Results:
Twenty eight patients were operated exclusively through an endoscopic endonasal approach. Fourteen patients were operated using a combined approach, associating either a vestibular (9 cases), a paralateral nasal (3 cases) or a fronto-orbital (2 cases) approach with endonsal endoscopy. In two cases, an associated squamous cell carcinoma was found. We observed a recurrence in 9.5% of the all cases and in 14.2% of the patients treated using a combined approach.
Conclusions:
Endoscopic endonasal surgery is a validated surgical approach for the treatment of sino-nasal inverted papilloma in that total tumor removal is possible. This approach is particularly indicated in medially-situated papillomas without frontal or maxillary extension. In all other cases, associating an external or dissimulated approach is usually necessary.
Insights
Endoscopic endonasal surgery effectively treats sino-nasal inverted papilloma, especially for medial tumors. Combined approaches may be needed for extensive cases, with recurrence rates analyzed.
Area of Science:
- Otolaryngology
- Neurosurgery
- Oncology
Background:
- Sino-nasal inverted papilloma (SNIP) is a rare benign tumor.
- Endonasal endoscopic surgery is a recognized treatment.
- Study evaluates endoscopic approach for SNIP.
Purpose of the Study:
- Assess endoscopic endonasal surgery for SNIP.
- Analyze recurrence and failure rates.
- Define optimal surgical approach indications.
Main Methods:
- Retrospective study of 42 SNIP patients over 10 years.
- Surgical technique based on CT/MRI findings.
- Minimum one-year follow-up.
Main Results:
- 28 patients treated endoscopically; 14 with combined approaches.
- Squamous cell carcinoma found in 2 cases.
- Recurrence rate: 9.5% overall, 14.2% for combined approaches.
Conclusions:
- Endoscopic endonasal surgery is validated for SNIP.
- Ideal for medial tumors without frontal/maxillary extension.
- External approaches necessary for extensive disease.
