Features of surgical tactics in patients with paranasal sinus inverted papilloma: a clinical case

Background. Inverted papilloma (IP), or transitional cell papilloma of the nasal cavity and paranasal sinuses, is a benign tumor, accounting for 0.4-7% of all neoplasms of the nasal cavity and paranasal sinuses, characterized by a high recurrence rate and possible transformation into squamous cell carcinoma. The surgery is the main method of treating IP. Open approaches, endoscopic endonasal methods, as well as their combinations are usually used. Description of the clinical case. The article presents a clinical case, on the example of which an assessment of the effectiveness and safety of endoscopic endonasal modified Denker approach to the maxillary sinus was performed. Patient M., 32 years old, with complaints of a violation of right-sided nasal breathing, constant right-sided nasal congestion and headache on the affected side, was admitted for planned surgical treatment at the ENT department of the Clinical Medical Center of the A.I. Yevdokimov Moscow State University of Medicine and Dentistry. Computer tomography revealed total opacification of the right half of the nose, the right-side maxillary sinus and ethmoid sinuses, the presence of the ossification in the posterolateral region of the maxxilary sinus, which was regarded as the site of the primary invagination of the tumor. endoscopic endonasal modified Denker approach to maxillary sinus was performed, with the removal of the entire medial and part of its anterior walls, removal of the tumor, total removal of the mucous membrane, and dissection of the site of ossification of the maxillary sinus. Conclusion. Endoscopic endonasal modified Denker approach to the maxillary sinus is accompanied by the possibility of direct or indirect through angular optics visualization of all the walls of the maxillary sinus, possibility of total removal of the tumor, and safe, controlled surgery in terms of blood loss and damage to critical neurovascular structures.

inverted papilloma, maxillary sinus, endoscopic endonasal modified Denker approach