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Transnasal endoscopic medial maxillectomy in inverted papilloma
1Department of Otolaryngology Head & Neck Surgery, Cairo University, Egypt.
Abstract:
This study comprised 17 cases of inverted papilloma, which were divided into two groups. The first group included 8 cases that lacked maxillary sinus involvement. They were subjected to intranasal endoscopic resection with safety margin. The second group included 9 cases involving the maxillary sinus with or without nasal extension. They were subjected to transnasal endoscopic medial maxillectomy. Follow-up for an average of 43 months in group 1 and 28 months in group 2 (excluding the 5 cases with less than 2 years of follow-up) showed no recurrence. The author realized that inverted papilloma can be divided into two groups from the anatomic and behavioral points of view and accordingly should be managed differently. For those lesions without involvement of the maxillary sinus, intranasal endoscopic resection is effective; for those lesions with maxillary sinus involvement, transnasal medial maxillectomy, which could be performed safely under endoscopic control, is recommended.
Insights
This study on inverted papilloma found distinct treatment approaches based on maxillary sinus involvement. Endoscopic resection is effective for tumors without sinus involvement, while medial maxillectomy is recommended for those with sinus extension, with no recurrences observed.
Area of Science:
- Otolaryngology
- Head and Neck Surgery
- Endoscopic Sinus Surgery
Background:
- Inverted papilloma is a benign but locally aggressive sinonasal tumor.
- Accurate diagnosis and appropriate surgical management are crucial to prevent recurrence.
- Differentiated treatment strategies based on tumor extent are essential.
Purpose of the Study:
- To evaluate the efficacy of different endoscopic surgical techniques for inverted papilloma based on tumor location.
- To compare outcomes for inverted papilloma with and without maxillary sinus involvement.
- To establish optimal surgical management guidelines for sinonasal inverted papilloma.
Main Methods:
- Retrospective analysis of 17 inverted papilloma cases.
- Group 1 (8 cases): Intranasal endoscopic resection for tumors without maxillary sinus involvement.
- Group 2 (9 cases): Transnasal endoscopic medial maxillectomy for tumors involving the maxillary sinus.
Main Results:
- No recurrence observed in either group after an average follow-up of 43 months (Group 1) and 28 months (Group 2).
- Intranasal endoscopic resection demonstrated effectiveness for tumors limited to the nasal cavity.
- Transnasal endoscopic medial maxillectomy proved safe and effective for maxillary sinus-invasive inverted papilloma.
Conclusions:
- Inverted papilloma management should be tailored to its anatomical extent.
- Intranasal endoscopic resection is suitable for non-maxillary sinus inverted papillomas.
- Transnasal endoscopic medial maxillectomy is the recommended approach for inverted papillomas invading the maxillary sinus.