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Updated: Jul 14, 2026
Lateral Molar Approach-Driven Transoral Endoscopic Procedure for Benign Infratemporal Fossa Tumor Resection
Published on: August 15, 2025
Minimally invasive resection of frontal recess/sinus inverted papilloma
Nathan B Sautter1, Martin J Citardi, Pete S Batra
1Section of Nasal and Sinus Disorders, Head and Neck Institute, Cleveland Clinic Foundation, Cleveland, OH 44195, USA.
Objective:
Inverted papilloma (IP) in the frontal recess/sinus poses a unique surgical challenge given the inherent difficulty in endoscopic visualization and limitations in access posed by the anatomic confines of the frontal recess/sinus. The objective of this study is to evaluate the efficacy of the minimally invasive endoscopic approach for resection of frontal recess/sinus IP.
Study Design:
Retrospective chart review.
Methods:
Five patients with frontal recess/sinus IP comprised the focus of this study. Patient charts were reviewed for demographic data, tumor location and extent, histopathology, surgical treatment strategy, operative parameters (operative time, blood loss), recurrence rate, and follow-up.
Results:
The average age was 55 years, and all patients were men. All patients underwent computer-aided endoscopic resection of histologically proven IP as the primary surgical modality. Adjunct approaches including endoscopic frontal trephination and modified endoscopic Lothrop were performed in 1 case each. No intra- or postoperative complications occurred in the patient group. No recurrences were noted by endoscopic and/or radiographic surveillance at mean follow-up of 16.8 months.
Conclusions:
The minimally invasive endoscopic approach is effective for successful resection of frontal recess/sinus IP. Adjunctive open approaches or extended frontal drill-out approaches may be required to achieve complete tumor extirpation. Careful preoperative planning coupled with meticulous surgical technique are absolute requisites for successful management of these difficult tumors.
Insights
The minimally invasive endoscopic approach effectively resects inverted papilloma (IP) in the frontal recess/sinus. This method showed no recurrence in a short follow-up, but complex cases may need additional surgical techniques.
Area of Science:
- Otolaryngology
- Neurosurgery
- Endoscopic Sinus Surgery
Background:
- Frontal recess/sinus inverted papilloma (IP) presents significant surgical challenges due to limited endoscopic visualization and narrow anatomical access.
- Traditional surgical approaches may involve more invasive methods, potentially leading to increased morbidity.
Purpose of the Study:
- To evaluate the efficacy and outcomes of the minimally invasive endoscopic approach for the resection of inverted papilloma located in the frontal recess and sinus.
Main Methods:
- A retrospective chart review was conducted on five patients diagnosed with frontal recess/sinus IP.
- Data collected included demographics, tumor characteristics, surgical strategy, operative parameters, and follow-up for recurrence.
Main Results:
- All five patients underwent computer-aided endoscopic resection as the primary treatment for histologically confirmed IP.
- No intra- or postoperative complications were observed, and no recurrences were detected at a mean follow-up of 16.8 months.
- Adjunctive procedures like endoscopic frontal trephination or modified endoscopic Lothrop were used in one case each.
Conclusions:
- The minimally invasive endoscopic approach is a viable and effective method for resecting frontal recess/sinus IP.
- Complete tumor extirpation may necessitate adjunctive open or extended endoscopic approaches in complex cases.
- Meticulous surgical technique and careful preoperative planning are crucial for successful management.
