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Wang G, Shen H, Chu Z, Shen J, Wang Y. Endoscopic transsphenoidal approach to a sphenoid sinus inverted papilloma combined with pituitary adenoma: a case report. Br J Neurosurg 2024; 38:202-204. [PMID: 32940105 DOI: 10.1080/02688697.2020.1820944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Revised: 07/05/2020] [Accepted: 09/04/2020] [Indexed: 10/23/2022]
Abstract
Sphenoid sinus inverted papilloma (IP) is a very infrequent tumor, and the combination of sphenoidal IP with pituitary tumor is extremely rare. In this report, the authors describe the case of a 63-year-old male with oculomotor nerve palsy in the left eye due to sellar region tumor. After endoscopic transsphenoidal surgery, the postoperative pathological examination confirmed the co-occurrence of an sphenoidal IP and pituitary adenoma. To our knowledge, the present case is the second reported case of an IP with a pituitary adenoma.
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Affiliation(s)
- GengHuan Wang
- Neurosurgery, the Second Affiliated Hospital of Jiaxing University, Jiaxing, China
| | - HePing Shen
- The Second Affiliated Hospital of Jiaxing University, Jiaxing, China
| | - ZhengMin Chu
- Neurosurgery, the Second Affiliated Hospital of Jiaxing University, Jiaxing, China
| | - JianGuo Shen
- Neurosurgery, the Second Affiliated Hospital of Jiaxing University, Jiaxing, China
| | - YiFei Wang
- Neurosurgery, the Second Affiliated Hospital of Jiaxing University, Jiaxing, China
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Vinciguerra A, Guichard JP, Verillaud B, Herman P. Extended sphenoidotomy combined with transpterygoid approach for sphenoidal sinus inverted papilloma. Eur Arch Otorhinolaryngol 2023; 280:5369-5378. [PMID: 37414940 DOI: 10.1007/s00405-023-08106-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 07/03/2023] [Indexed: 07/08/2023]
Abstract
PURPOSE Inverted papilloma of the sphenoid sinus (IPSS) is a rare tumor with debated surgical management due to its proximity to vital structures. The aim of this manuscript is to highlight the role of a transpterygoid approach (TPA) and pedicle-orientated strategy in case of involvement of critical structures in IPSS and compare it with data from the literature. METHODS Patients with primary IPSS between January 2000 and June 2021 were included. Pre-operative CT/MRI were analyzed to classify the pneumatization of the SS and predict the insertion point of the inverted papilloma. All patients were treated with a trans-sphenoidal approach which was combined with a TPA in case of lateral insertion point. A systematic search was also performed to summarize the available literature. RESULTS Twenty-two patients were treated for IPSS. By CT, the SS was categorized with type III pneumatization in 72.8% of cases. Eleven patients (50%) were treated with a TPA with a statistical association with the insertion point on the SS lateral wall (p = 0.01), rather than a SS pneumatization (p = 0.63). The overall success was 95.5% after a mean follow-up of 35.9 months. For the literature, 26 publications were included on 97 patients and described a trans-sphenoidal approach with a success rate of 84.6% after a mean follow-up of 24.5 months. CONCLUSION IPSS is generally treated with a sphenoidotomy approach, although in selected cases, a TPA should be preferred to expose the whole SS lateral wall though allowing a complete pedicled oriented resection of the tumor.
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Affiliation(s)
- Alessandro Vinciguerra
- Otorhinolaryngology and Skull Base Center, AP-HP, Hospital Lariboisière, 2 Rue Ambroise Paré, 75010, Paris, France.
| | | | - Benjamin Verillaud
- Otorhinolaryngology and Skull Base Center, AP-HP, Hospital Lariboisière, 2 Rue Ambroise Paré, 75010, Paris, France
| | - Philippe Herman
- Otorhinolaryngology and Skull Base Center, AP-HP, Hospital Lariboisière, 2 Rue Ambroise Paré, 75010, Paris, France
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Ho AKH, Brinkman D, Khan MH. Inverted papilloma of the sphenoid sinus – A case report. OTOLARYNGOLOGY CASE REPORTS 2020. [DOI: 10.1016/j.xocr.2020.100173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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Simultaneous Resection of Pituitary Macroadenoma and Sphenoid Sinus Inverted Papilloma: The Challenge of Operating Sinonasal and Skull Base Pathologies Through a Single-Stage Endoscopic Endonasal Approach. World Neurosurg 2019; 133:260-265. [PMID: 31605847 DOI: 10.1016/j.wneu.2019.09.159] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Revised: 09/27/2019] [Accepted: 09/28/2019] [Indexed: 11/24/2022]
Abstract
BACKGROUND Coexistence of sinonasal and skull base tumors is uncommon but possible, and the endonasal route seems to be the best option to manage both lesions simultaneously. We report the first case in the English literature of concomitant sphenoid sinus inverted papilloma and pituitary macroadenoma treated through an endoscopic endonasal approach. CASE DESCRIPTION A 68-year-old man presented with a history of progressive visual loss and nasal obstruction. Clinical examination disclosed bitemporal hemianopsia. Computed tomography scan and magnetic resonance imaging obtained on admission showed a large sellar/suprasellar enhancing lesion with a marked mass effect on the optic chiasm. Imaging also showed a second mass extending from the sphenoid sinus to the left nasal cavity with obstruction of the maxillary sinus ostium and development of maxillary sinus mucocele. Both tumors were entirely resected by an endoscopic endonasal approach. Additionally, middle meatal antrostomy and marsupialization with drainage of the maxillary mucocele was performed. Biopsy confirmed the coexistence of a pituitary macroadenoma and sphenoid sinus inverted papilloma. CONCLUSIONS This case and the literature suggest that patients with concomitant nasal and skull base pathologies can be simultaneously managed. The otolaryngologist plays an essential role in removing the sinonasal lesion to ensure a safe surgical corridor before entering the intracranial cavity and for planning for the skull base reconstruction.
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Peng R, Thamboo A, Choby G, Ma Y, Zhou B, Hwang PH. Outcomes of sinonasal inverted papilloma resection by surgical approach: an updated systematic review and meta‐analysis. Int Forum Allergy Rhinol 2019; 9:573-581. [DOI: 10.1002/alr.22305] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2018] [Revised: 12/20/2018] [Accepted: 01/08/2019] [Indexed: 12/18/2022]
Affiliation(s)
- Rui Peng
- Department of Otolaryngology–Head and Neck SurgeryStanford University School of Medicine Stanford CA
- Department of Otolaryngology–Head and Neck Surgery, Beijing Tongren HospitalCapital Medical University Beijing China
| | - Andrew Thamboo
- Department of Otolaryngology–Head and Neck SurgeryStanford University School of Medicine Stanford CA
- Department of Surgery, Division of OtolaryngologyUniversity of British Columbia Vancouver BC Canada
| | - Garret Choby
- Department of Otolaryngology–Head and Neck SurgeryStanford University School of Medicine Stanford CA
- Department of Otorhinolaryngology–Head and Neck SurgeryMayo Clinic Rochester MN
| | - Yifei Ma
- Department of Otolaryngology–Head and Neck SurgeryStanford University School of Medicine Stanford CA
| | - Bing Zhou
- Department of Otolaryngology–Head and Neck Surgery, Beijing Tongren HospitalCapital Medical University Beijing China
| | - Peter H. Hwang
- Department of Otolaryngology–Head and Neck SurgeryStanford University School of Medicine Stanford CA
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Liu Y, Duan L, Tian J, Song D, Zhang M, Zhao S, Yin Z, Xiang X, Li X. Role of the Akt/mTOR signaling pathway in human papillomavirus-associated nasal and sinonasal inverted papilloma. Acta Biochim Biophys Sin (Shanghai) 2017; 49:1067-1074. [PMID: 29040365 DOI: 10.1093/abbs/gmx108] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2017] [Indexed: 11/12/2022] Open
Abstract
Nasal and sinonasal inverted papilloma (NSIP) is a benign tumor in which surface epithelial cells grow downward into the underlying supportive tissue with varying degrees of metaplasia. Human papillomavirus (HPV) has been proposed as the causal agent in the pathogenesis of this disease. Many studies have shown that HPV can activate the Akt/mechanistic target of rapamycin (mTOR) signaling pathway, but the role of this pathway in HPV-associated NSIP is largely unknown. In this study, we enrolled 40 control tissue samples and 80 NSIP tissue samples. HPV genotyping showed that 47 of the 80 examined cases of NSIP were HPV-positive (58.8%), and the most common subtype was HPV11 (20/53, 37.7%). The immunohistochemistry showed statistically significant differences in phosphorylated Akt and phosphorylated S6 ribosomal protein staining among control samples, HPV-positive NSIP and HPV-negative NSIP. The HPV11 L1-L2 plasmid increased the proliferation of normal human nasopharyngeal epithelial NP69-SV40T cells and human nasopharyngeal cancer CNE1 cells. Meanwhile, rapamycin, an mTOR inhibitor, reversed the increased cell proliferation induced by the HPV11 L1-L2 plasmid. Western blot analysis showed that Akt/mTOR/S6 were overexpressed in NP69-SV40T cells and CNE1 cells infected with the HPV11 L1-L2 plasmid. These data demonstrate that HPV promotes cell proliferation through the Akt/mTOR signaling pathway in NSIP.
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Affiliation(s)
- Yongliang Liu
- Department of Otolaryngolgogy, Qilu Hospital of Shandong University, Jinan, China
- Department of Otolaryngolgogy, Zibo Central Hospital affiliated to Shandong University, Zibo, China
| | - Lihua Duan
- Department of Otolaryngolgogy, Zibo Central Hospital affiliated to Shandong University, Zibo, China
| | - Jie Tian
- Department of Otolaryngolgogy, Zibo Central Hospital affiliated to Shandong University, Zibo, China
| | - Daoliang Song
- Department of Otolaryngolgogy, Zibo Central Hospital affiliated to Shandong University, Zibo, China
| | - Min Zhang
- Department of Otolaryngolgogy, Zibo Central Hospital affiliated to Shandong University, Zibo, China
| | - Shenlin Zhao
- Department of Otolaryngolgogy, Zibo Central Hospital affiliated to Shandong University, Zibo, China
| | - Zhaofu Yin
- Department of Otolaryngolgogy, Zibo Central Hospital affiliated to Shandong University, Zibo, China
| | - Xinxin Xiang
- Central of Translation Medicine, Zibo Central Hospital affiliated to Shandong University, Zibo, China
| | - Xuezhong Li
- Department of Otolaryngolgogy, Qilu Hospital of Shandong University, Jinan, China
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Akkari M, Lassave J, Mura T, Gascou G, Pierre G, Cartier C, Garrel R, Crampette L. Atypical presentations of sinonasal inverted papilloma: Surgical management and influence on the recurrence rate. Am J Rhinol Allergy 2016; 30:149-54. [PMID: 26980397 DOI: 10.2500/ajra.2016.30.4288] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Sinonasal inverted papilloma (SNIP), classically, is a unilateral benign tumor of the nasal lateral wall. Numerous variations have been observed, depending on location, bilateral presentation, or association with nasal polyposis. OBJECTIVE The aim of this work was to describe atypical presentations of SNIPs with their management specificities and to assess their influence on the recurrence rate in a large case series. METHODS A retrospective single center study of 110 patients treated for SNIP. Atypical inverted papillomas were identified according to the following criteria: (1) unusual location (frontal, posterior, anterior), (2) bilateral involvement, and (3) association with nasal polyposis. Surgical management was detailed, and the influence of each atypical group on recurrence was assessed by using Kaplan-Meier survival curves and the log-rank test. RESULTS Distribution of atypical presentations was as follows: frontal sinus localization (10.9%); posterior localization, including sphenoid sinus (9%); nasal anterior localization (3.6%); bilateral involvement (3.6%); and nasal polyposis association (10%). The surgical approach was endoscopic (74.5%), external (5.5%), or combined endoscopic and external (20%). Except for nasal anterior localization, all the groups were associated with a higher recurrence rate, without reaching statistical significance. CONCLUSION Recurrence rates for these atypical presentations arise from their specific surgical challenges. The choice of the surgical technique is guided by tumor location and extension, and by the surgeon's experience; the main objective is a complete resection. The endoscopic endonasal approach is the most frequent procedure.
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Affiliation(s)
- Mohamed Akkari
- Department of Ear, Nose and Throat and Head and Neck Surgery, University Hospital Gui de Chauliac, University of Montpellier, Montpellier, France
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Suh JD, Ramakrishnan VR, Thompson CF, Woodworth BA, Adappa ND, Nayak J, Lee JM, Lee JT, Chiu AG, Palmer JN. Inverted papilloma of the sphenoid sinus: risk factors for disease recurrence. Laryngoscope 2014; 125:544-8. [PMID: 25418985 DOI: 10.1002/lary.24929] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2014] [Revised: 08/06/2014] [Accepted: 08/25/2014] [Indexed: 12/25/2022]
Abstract
OBJECTIVES/HYPOTHESIS Surgical treatment of inverted papilloma (IP) of the sphenoid sinus is complicated by close proximity to vital structures of the skull base. Identifying the site of tumor attachment and achieving complete removal can be challenging compared to IP at other sites. The objective of this study is to illustrate the clinical presentation, management, and risk factors for tumor recurrence for sphenoid IP. STUDY DESIGN Retrospective study. METHODS A multi-institutional, retrospective review of endoscopic resections of IP based within the sphenoid sinus was performed from 1996 to 2014. Demographic and tumor data, operative notes, complications, and recurrence rates were collected. Statistical analysis was performed to identify risk factors for tumor recurrence. RESULTS Forty-eight patients (31 males, 17 females) were identified. Mean age was 57 years, with a median follow-up of 13.6 months (range 6.8-36). Rate of tumor recurrence was 14.6%, with median time to recurrence of 13.1 months. Patients with dysplasia/carcinoma in situ (CIS) had a 3.6 greater rate of recurrence (RR) compared to patients with no dysplasia, approaching significance (RR = 3.6; P = 0.08). Patients with IP attachment sites overlying the optic nerve or carotid artery had a 4.76 greater rate of recurrence compared to other sites (RR = 4.76; P = 0.073). CONCLUSION Sphenoid sinus IP is associated with a 14.6% rate of recurrence after surgery. Potential risk factors for tumor recurrence identified in this study include attachment sites over the optic nerve and carotid artery or evidence of dysplasia or CIS. Close follow-up in the postoperative period is essential for these patients to monitor for tumor recurrence.
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Affiliation(s)
- Jeffrey D Suh
- Department of Head and Neck Surgery, University of California, Los Angeles, Los Angeles
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Rabelo GFN, Freitas VA, Santos BH, Ferreira DCDS, Magalhães AEMS, Castro MCMD. Sphenoid sinus inverted papilloma: a case report and literature review. Int Arch Otorhinolaryngol 2014; 18:332-5. [PMID: 25992117 PMCID: PMC4297015 DOI: 10.1055/s-0034-1370761] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2013] [Accepted: 12/02/2013] [Indexed: 11/18/2022] Open
Abstract
Introduction Inverted papilloma is a rare benign tumor of the nasal fossa, which usually originates from its lateral wall. Only 5% of cases demonstrate exclusive sinus involvement. Primary sphenoid sinus involvement is even rarer. Although considered a benign lesion, the tumor has a potentially invasive nature and has also been found to have an associated malignancy rate of 7 to 15%. Objectives To report a case of inverted nasal papilloma originating in a rare location: the sphenoid sinus. Resumed Report a 56-year-old woman, presented to our outpatient clinic complaining of frontal headache, occasional otalgia and recent forgetfulness. She was initially evaluated by a neurologist and then submitted to a head magnetic resonance imaging. A lesion was found to be filling both sphenoid sinuses. Sinus computed tomography showed an opacified sphenoid sinus with apparent bony integrity. The patient underwent sphenoidotomy through a transnasal endoscopic approach. A bleeding papillomatous lesion was identified. A biopsy was performed and histopathologic study suggested inverted papilloma. The lesion was then completely resected. The patient has been followed for 60 days after surgery; no signs of recurrence were found upon flexible nasofibroscope examination. Conclusion Inverted Papilloma exclusively involving the sphenoid sinus is a rare entity. Non specific symptomatology and Clinical presentation make this kind of tumor a diagnostic and therapeutic challenge. The Endoscopic Sphenoidotomy has been the treatment of choice. Close follow-up is required in order to detect possible recurrences and malignant transformation.
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Affiliation(s)
| | - Vinícius Antunes Freitas
- ENT, Head and Neck Surgeon, Otorhinolaryngology Department, Santa Casa de Belo Horizonte, Belo Horizonte, MG, Brazil
| | - Bruno Hollanda Santos
- Post graduation student, Otorhinolaryngology Department, IEP Santa Casa de Belo Horizonte
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Tam YY, Chen CK, Chang KP. Sphenoethmoidal inverted papilloma causing ipsilateral abducens nerve palsy. Otolaryngol Head Neck Surg 2013; 148:703-4. [PMID: 23314158 DOI: 10.1177/0194599812473236] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Yuan-Yun Tam
- Department of Otolaryngology-Head & Neck Surgery, Chang Gung Memorial Hospital & Chang Gung University College of Medicine, Kwei-Shan, Tao-Yuan, Taiwan
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Cheng K, Chen H, Zhou S, Wang S, Zhong B. Isolated inverting papilloma of the sphenoid sinus: clinical presentations, imaging manifestations, and therapeutic strategies. J Craniofac Surg 2013; 23:1109-14. [PMID: 22777475 DOI: 10.1097/scs.0b013e31825434fc] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Isolated inverting papilloma (IP) of the sphenoid sinus is rare, with about 50 patients reported in the English-language literature. With its rarity, scientists have paid less attention to the clinical and radiographic characteristics of isolated IPs arising from the sphenoid sinus. METHODS We describe the clinical presentation, imaging manifestations, and surgical methods of isolated IPs from the sphenoid sinus in 3 patients and review the English-language literature from 1970 to 2011. RESULTS In total, 59 cases of isolated sphenoid sinus IPs (including our cases) have been reported, 40 patients with computed tomography or magnetic resonance imaging details. The most common presentation is headache. Lesions were found in the sphenoethmoidal recess in 26 cases. In 8 patients who underwent enhanced magnetic resonance imaging, the tumor was obviously intensified. We found 26 patients with bony destruction, and 8 lesions revealed the correct tumor origin. CONCLUSIONS A polyp-like mass in the sphenoethmoidal recess strongly implied the diagnosis of an IP in the sphenoid sinus. Bony destruction on computed tomography is a common characteristic of this disease and had a close relationship with the original tumor site in our study. Malignant transformation of IPs in the sphenoid sinus is much scarcer.
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Affiliation(s)
- Kejia Cheng
- Department of Otolaryngology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, People's Republic of China.
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Carta F, Blancal JP, Verillaud B, Tran H, Sauvaget E, Kania R, Herman P. Surgical management of inverted papilloma: approaching a new standard for surgery. Head Neck 2012; 35:1415-20. [PMID: 23002029 DOI: 10.1002/hed.23159] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/11/2012] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Inverted papilloma surgery is currently performed primarily with an endoscopic approach, a technique that has a recurrence rate of 12%. However, a recent study reported a recurrence rate of 5% with a strategy based on subperiosteal dissection of the tumor, with limited indications for using an external approach. The aim of this work was to evaluate whether different teams using the same surgical concepts could reproduce the excellent results that were recently reported. METHODS This study is a retrospective chart review of 71 consecutive patients with inverted papilloma who were treated during the last 10 years. RESULTS In all, 80% of the patients were treated using a purely endoscopic approach. The mean follow-up period was 31.6 months. The recurrence rate was 3.3% for cases with at least a 12-month follow-up. CONCLUSIONS This work confirms the results described in recent literature and further supports transnasal endoscopic surgery to manage inverted papilloma.
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Affiliation(s)
- Filippo Carta
- Assistance Publique-Hôpitaux de Paris, Department of Ear, Nose and Throat, Hôpital Lariboisière, Université Paris-Diderot, Paris, France
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In Inverted Papillomas HPV more likely represents incidental colonization than an etiological factor. Virchows Arch 2011; 459:529-38. [DOI: 10.1007/s00428-011-1139-1] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2011] [Revised: 08/10/2011] [Accepted: 08/16/2011] [Indexed: 10/17/2022]
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Current world literature. Curr Opin Otolaryngol Head Neck Surg 2011; 19:58-65. [PMID: 21233627 DOI: 10.1097/moo.0b013e32834344aa] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Abstract
PURPOSE OF REVIEW The aim of this work, based on a recent review of the literature concerning sinonasal inverted papilloma, is to describe the diagnostic strategy for inverted papilloma and to propose an algorithm for the choice of surgical techniques, based on recent results of clinical series. RECENT FINDINGS Traditionally, inverted papilloma was managed through an open approach. Endoscopic techniques have been developed, first combined with an open approach, and then exclusively endoscopic with the advent of medial maxillectomy and median drainage or Draf procedures. Numerous case series strongly support that they now represent the treatment modality of choice. SUMMARY This is a review concerning recent findings about inverted papilloma, based on recent literature revision.Diagnosis of inverted papilloma has to be made before surgery, and planning of the surgical strategy is based on the comparison of computed tomography and MRI, with the aim of targeting the insertion of the tumor. With the help of expanded surgical procedures, endoscopic surgery has become the gold standard for the treatment of the vast majority of inverted papilloma. In case of massive frontal or supraorbital extensions, the frontal osteoplastic flap is the complementary approach of choice.
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Liu SC, Lee JC, Chen JJ, Lin YS. Isolated inverted papilloma of the sphenoid sinus. J Chin Med Assoc 2010; 73:503-5. [PMID: 20875627 DOI: 10.1016/s1726-4901(10)70108-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2009] [Accepted: 06/29/2010] [Indexed: 10/19/2022] Open
Abstract
Primary inverted papilloma of the sphenoid sinus is rare. Such a case, of a 42-year-old female, is reported here, discussing the clinical presentation, diagnostic clues, radiographic features, histological findings and management. In contrast to the vast majority of cases that present with nasal complaints because of lateral nasal wall involvement, the clinical presentation of inverted papillomas confined to the sphenoid sinus is often nonspecific and insidious. Nasal endoscopy and radiologic imaging are key to an accurate diagnosis. Preoperative imaging with computed tomography and the surgeon's experience will dictate the appropriate surgical approach. In our opinion, transnasal endoscopic large sphenoidotomy remains an effective modality for management of patients with this lesion when the sphenoid sinus is the only sinus requiring investigation. A more anatomically directed approach to the sphenoid sinus with less violation of other sinuses can be achieved.
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Affiliation(s)
- Shao-Cheng Liu
- Department of Otolaryngology-Head and Neck Surgery, Tri-Service General Hospital, National Defense Medical Center, 325 Cheng-Kung Road, Taipei, Taiwan
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