Nasopharyngeal papilloma


nasopharyngeal papilloma

The procedure implies surgical excision of the lateral nasal wall and ethmoid sinus. This technique is aided by the usage of adequate instruments, such as 0° and 70° scopes and angulated surgical in­struments, which allow the complete visualization and access to the maxillary sinus.

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The authors present, as an endoscopic surgical nasopharyngeal papilloma, step by step, the surgical procedure for endoscopic approach of inverted papilloma, in order to reach a complete tumor removal without any leftovers.

Keywords medial maxillectomy, inverted papilloma, endoscopic sinus surgery Rezumat Tehnica maxilectomiei mediale reprezintă standardul de aur în tratamentul chirurgical al papilomului inversat, deoarece oferă o expunere adecvată nasopharyngeal papilloma peretelul nazal lateral şi a sinusului maxilar. Intervenţia include excizia chirurgicală a peretelui nazal lateral şi a sinusului etmoidal. Această tehnică nasopharyngeal papilloma posibilă prin folosirea instrumentarului adecvat, a tijelor de 0° şi 70° şi a instrumentelor chirurgicale angulate, care nasopharyngeal papilloma vizualizarea şi accesul complet spre sinusul maxilar.

Endoscopic medial maxillectomy for inverted papilloma

Autorii prezintă, ca un atlas de chirurgie endoscopică, paşii acestei tehnici chirurgicale de abord endoscopic al papilomului inversat, în vederea exciziei complete a tumorii, fără nicio restanţă. Cuvinte cheie maxilectomie medială papilom inversat chirurgie nasopharyngeal papilloma endoscopică Introduction Inverted papilloma represents an invasive, unilate­ral, benign tumoral mass, which has its origin in the nasal mucosa and presents a risk of malignancy.

It is most commonly located on the lateral nasal wall, extended to the maxillary and ethmoid sinus 1. When it has nasopharyngeal papilloma origin in the maxillary sinus, the elected technique is nasopharyngeal papilloma by endoscopic medial maxillectomy.

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Medial maxillectomy aims to enable the access nasopharyngeal papilloma the maxillary sinus, superior to the combined middle and inferior meatus approach. In the last decades, with the development of endoscopic and imagistic techniques, the endoscopic approach replaced the external procedures, as it presents similar success rates, lower morbidity and better esthetic outcomes for the patient 2. Also, endoscopic approach was proven to allow the better evaluation of nasal mucosa.

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nasopharyngeal papilloma The indications for endoscopic medial maxillectomy include inverted papilloma, nasopharyngeal angiofibroma and pterygomaxillary fossa pathology nasopharyngeal papilloma.

The diagnostic protocol depends on a computed tomography, which illustrates the extension and place of attachment of the tumor. This image shows the left maxillary sinus completely occupied nasopharyngeal papilloma a tumoral nasopharyngeal papilloma, extended to the left nasal fossa, hyperostosis of the maxillary sinus walls and an anterior bony thickening, representing the origin of the tumor Figure 1.

Nasopharyngeal papilloma 1.

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CT image, coronal section, showing complete blockage of the maxillary sinus, hyperostosis and tumoral origin arrow The first surgical step includes antero-posterior ethmoidectomy, with the nasopharyngeal papilloma of the tumor from this level and from the middle meatus.

We used a piece-meal resection, using bipolar electrocoagulation for hemostasis Figure 2.

Nasopharyngeal papilloma

Figure 2. Intraoperative aspect of ethmoidectomy with tumor excision After ethmoidectomy and clearing of the middle meatus, the resection of the inferior turbinate and sinonasal wall is performed.

This technique allows a complete resection of the tumor nasopharyngeal papilloma a good visualisation of the maxillary sinus extensions Figure 3.

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Figure 3. Endoscopic resection of the inferior turbinate and lateral nasal wall Medial maxillectomy offers an optimal access to the maxillary sinus, with the complete resection of human papillomavirus symptoms in urdu tumor and the nasopharyngeal papilloma of the tumor origin.

Maxilectomia maxilară medială pentru papilomul inversat

It represents the key point of tumor resection in order to avoid any leftovers Figure 4. Figure 4.

  1. Maxilectomia maxilară medială pentru papilomul inversat
  2. Papilloma nasopharynx. Maxilectomia maxilară medială pentru papilomul inversat
  3. Human papillomavirus and nasopharyngeal cancer that time, new data have become available, these have been incorporated into the Monograph, and taken into consideration in the present evaluation.
  4. Nasopharyngeal papilloma. FfCancerul de Col Uterin Gg

The identification of the tumor origin using the 70° scope The deperiostation of the tumor attachment is required, as it lowers the risk of recurrence. We can succeed in this procedure using an angulated curette Figure 5 or an angulated diamond burr, depending on nasopharyngeal papilloma position of the bony stalk or hyperostosis.

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Figure 5. The deperiostation of tumor origin Final image of the widely opened medial maxillectomy ostium and resorbable sponge applied in the maxillary sinus.

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This procedure does not require the usage of a nasopharyngeal papilloma sponge Figure 6. Figure 6. Final image with resorbable sponge applied Conclusions Inverted papilloma is a benign tumor with recurrence and malignancy potential.

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Recurrence is in fact a tumoral residue. The endoscopic medial maxillectomy is the elected technique for complete tumoral resection and ensures a superior approach to the maxillary sinus and also lowers the risk of recurrence. Conflict of interests: The authors declare no conflict of interests.

Sinonasal inverted papilloma: A case report and mini review of histopathological features.

Human papillomavirus and nasopharyngeal cancer

Journal of Oral and Maxillofacial Pathology. Cunningham K, Welch K. Endoscopic medial maxillectomy. Operative Techniques in Otolaryngology. Transnasal endoscopic medial maxillectomy for inverting papilloma. The Laryngoscope.

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