gms | German Medical Science

81st Annual Meeting of the German Society of Oto-Rhino-Laryngology, Head and Neck Surgery

German Society of Oto-Rhino-Laryngology, Head and Neck Surgery

12.05. - 16.05.2010, Wiesbaden

Endoscopic Removal of Inverted Papilloma with Extension to Frontal Sinus

Meeting Abstract

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Deutsche Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie. 81. Jahresversammlung der Deutschen Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie. Wiesbaden, 12.-16.05.2010. Düsseldorf: German Medical Science GMS Publishing House; 2010. Doc10hnod561

DOI: 10.3205/10hnod561, URN: urn:nbn:de:0183-10hnod5618

Published: April 22, 2010

© 2010 Davris.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.


Outline

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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.