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Modification of endoscopic medial maxillectomy: a novel approach for inverted papilloma of the maxillary sinus

Published online by Cambridge University Press:  26 January 2015

A Ghosh ,
S Pal ,
A Srivastava  and
S Saha
A Ghosh*
Affiliation:
Department of Otolaryngology, MGM Medical College, Kishanganj, India
S Pal
Affiliation:
Department of Otolaryngology, R G Kar Medical College, Kolkata, India
A Srivastava
Affiliation:
Swastik ENT Centre, Ranchi, India
S Saha
Affiliation:
Department of Otolaryngology, National Medical College, Kolkata, India
*
Address for correspondence: Dr A Ghosh, Hope Nursing Home, A/88 NSB Road (East) PO-Searsole-Rajbari, PS-Raniganj, DT-Burdwan, West Bengal, India E-mail: [email protected]
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Abstract

Objective:

To describe modification to endoscopic medial maxillectomy for treating extensive Krouse stage II or III inverted papilloma of the nasal and maxillary sinus.

Method:

Ten patients with inverted papilloma arising from the nasoantral area underwent diagnostic nasal endoscopy, contrast-enhanced computed tomography scanning of the paranasal sinus and pre-operative biopsy of the nasal mass. They were all managed using endoscopic medial maxillectomy and followed up for seven months to three years without recurrence.

Results:

Most patients were aged 41–60 years at presentation, and most were male. Presenting symptoms were nasal obstruction, mass in the nasal cavity and epistaxis. In each case, computed tomography imaging showed a mass involving the nasal cavity and maxillary sinus, with bony remodelling. The endoscopic medial maxillectomy approach was modified by making an incision in the pyriform aperture and removing part of the anterolateral wall of the maxilla bone en bloc.

Conclusion:

Modified endoscopic medial maxillectomy providing full access to the maxillary and ethmoid sinuses is described in detail. This effective, reproducible technique is associated with reduced operative time and morbidity.

Keywords

PapillomaNasal PolypsMaxillary Sinus
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 129 , Issue 2 , February 2015 , pp. 159 - 163
Copyright
Copyright © JLO (1984) Limited 2015 

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Footnotes

Presented by Dr A Ghosh at the 66th National Conference of the Association of Otolaryngologists of India, 11 January 2014, Mysore, India, and awarded 2nd prize in the best original paper category at the prestigious PA Shah Junior consultant award session.

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