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Frontal sinus inverted papilloma managed with Draf III
Mohammed Jihad Al Mahdi1, Mohammed Asiri1, Majed Pharaon2
1Department of Otolaryngology, King Abdulaziz Medical City, Riyadh, Saudi Arabia.
Journal of Surgical Case Reports
|August 29, 2020
Summary
Inverted papilloma (IP) of the frontal sinus is rare and locally aggressive. Complete resection via the Draf III procedure offers a successful surgical strategy for this challenging condition.
Area of Science:
- Otolaryngology
- Neurosurgery
- Oncology
Background:
- Inverted papilloma (IP) is a rare benign tumor of sinonasal mucosa.
- It exhibits local aggressiveness and a 7-15% risk of malignant transformation.
- Frontal sinus (FS) IP management is challenging due to rarity and invasiveness.
Observation:
- A 52-year-old male presented with bilateral nasal obstruction and left eye proptosis.
- CT revealed IP in frontal, ethmoid, and sphenoid sinuses, extending into nasal cavities, postnasal space, and left orbit with bony erosion.
- Transnasal endoscopic biopsy confirmed IP.
Findings:
- The IP was completely resected using the Draf III endoscopic sinus surgery technique.
- The patient recovered well with no symptoms one month post-surgery.
Implications:
- The Draf III procedure is a viable and effective surgical approach for managing complex frontal sinus inverted papillomas.
- Early diagnosis and complete resection are crucial for favorable outcomes and preventing malignant transformation.
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