Intranasal endoscopic prelacrimal recess approach for maxillary sinus inverted papilloma

Abstract

PurposeThis study aims to determine the indications and effectiveness of transnasal endoscopic prelacrimal recess approach (PLRA) in patients with maxillary sinus inverted papilloma (IP).MethodsWe retrospectively analyzed 71 patients treated in our institution for maxillary sinus IP between August 2008 and April 2015. 20 patients underwent endoscopic surgery via PLRA. All the patients who had postoperative follow-up for 3 years were enrolled. Demographic data, surgical technique, location of IP attachment, intra- and postoperative complications, follow-up duration and recurrence were recorded.ResultsThe outpatient follow-up period was 3–10 years after surgery. Recurrence of IP was seen in 6 (8.5%) of 71 patients, including 1 patient in the PLRA group. The recurrence rate was 5% in the PLRA group. Six of 71 patients experienced postoperative complications, but none was observed in the PLRA group.ConclusionTransnasal endoscopic PLRA is a minimally invasive, safe and effective method for maxillary sinus IP. The indication for PLRA is tumor pedicle located on the antero-inferior or infero-lateral wall or at multiple attachment sites of the maxillary sinus.

Modified endoscopic Denker approach in management of inverted papilloma of the anterior maxillary sinus

“…As mentioned previously, multiple techniques have been described to access these difficult to reach aspects of the maxillary sinus, including expanded medial maxillectomies as well as the transseptal, prelacrimal recess, canine fossa trephine, and Caldwell‐Luc approaches . In the Wu et al series of 28 patients with maxillary IPs, all were successfully removed with an endoscopic medial maxillectomy and addition of a transseptal approach for those lesions originating from the anterior wall .…”

“…Furthermore, patients with scarring from prior septal surgery or trauma may not be candidates for transseptal procedures . The prelacrimal recess approach has also been reported to have a 4% incidence of alar collapse . In addition, canine fossa trephination or Caldwell‐Luc approaches may come through the tumor itself, which is not ideal for complete visualization of the attachment site and removal of the bone in this region.…”

“…Despite these advances, there are still certain regions of the sinuses that are difficult to access through standard endoscopic approaches, such as specific areas of the frontal and maxillary sinuses. Expanded endoscopic approaches have been discussed in the literature in efforts to access the more lateral and anterior aspects of the maxillary sinus, including endoscopic medial maxillectomy, transseptal approaches, and the prelacrimal recess approach . However, there are still situations when combined approaches involving an endoscopic endonasal procedure in conjunction with a canine fossa trephine or Caldwell‐Luc approach are utilized to access the anterior maxillary wall, lateral maxillary wall, and anterior/inferior maxillary IPs .…”

Clinical outcome of endonasal endoscopic prelacrimal approach in managing different maxillary pathologies

“…In the surgical treatment of diseases originating from different sites of the maxillary sinus, the endoscopic pre-lacrimal approach makes possible the management of almost any aspect of internal linings. Especially the anterior and inferior aspect (e.g., alveolar recess and PLR), which are locations that traditional surgical corridors can hardly access (Nakamaru et al, 2010;Zhou et al, 2013Zhou et al, , 2016Lee et al, 2019;Zhou et al, 2018;Yu et al, 2018;Lin, Lin & Yeh, 2018). In select cases in which disease is located far laterally, surgeons can drill the pyriform aperture and/or part of anterior maxillary wall to extend surgical fulcrum (Turri-Zanoni et al, 2017;Nakamaru et al, 2010;Zhou et al, 2013).…”

“…The use of the EPLA has been reported to provide results comparable to those of conventional external procedures (Lee et al, 2019). However, its application has mostly been focused on the removal of neoplasms and no studies have been performed to assess post-treatment life-quality following EPLA (Lee et al, 2019;Zhou et al, 2018;Yu et al, 2018;Lin, Lin & Yeh, 2018). Therefore, in this study, we retrospectively reviewed the clinical applications of endoscopic PLR approach in the surgical treatment of different maxillary pathologies.…”