Artikel
Endoscopic Removal of Inverted Papilloma with Extension to Frontal Sinus
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Veröffentlicht: | 22. April 2010 |
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Gliederung
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Introduction: Inverted Papillomas are benign lesions with a high recurrence rate (RR)after their excision. After their removal with external approaches the RR is approximately 19% and after endoscopic resection a RR of 12%. ( Endoscopic Resection of Sinonasal Inverted Papilloma: A Meta-analysis - Head and Neck Surgery, 2006) Concomitant malignancy is about 8%. In unilateral polyps the incidence of IP is approximately 15%.
Methods & results: Of 35 patients with IP, four patients had an extension to the Frontal Sinus (Krouse Stage T3)
The primary treatment was endoscopic removal with drilling of the lateral nasal wall and fronto-nasal duct. It was successful in three cases. In the fourth patient, although I performed Draff III type procedure, the drilling of the frontal sinus was not adequate. The patient underwent a combined technique with osteoplastic and endoscopic approaches. A titanium mesh was placed over the eroded left orbital roof.
Conclusion: Although endoscopic approach is very well established for the majority of these cases, in particular patients it must be combined with other approaches.