[Endoscopic management of the inverted papilloma involving frontal sinus and its drainage pathway].
OBJECTIVE
The endoscopic management of inverted papilloma has gained increasing popularity over the last 15 years. However, the appropriate management of lesions involving the frontal sinus and its drainage pathway still has to be determined.


METHODS
We performed a retrospective review of the results of the patients with inverted papilloma in the Otolaryngology Head and Neck Surgery department, Beijing Tongren Hospital from 2004 to 2007 to identify the patients with lesions involving frontal sinus and its drainage pathway. By its appearance on nasal endoscopic examination and CT scanning, the tumors were defined using Krouse staging system. Sinus endoscopy was used to screen for disease after endoscopic resection. And their clinical outcomes were analyzed.


RESULTS
A total of nine patients (8 males and one female) with inverted papilloma who had frontal sinus and its drainage pathway involvement were identified. All tumors were defined as T3 lesions. Preoperative and postoperative pathologic examinations revealed inverted papilloma as the diagnosis. Four cases with lateral wall of frontal recess attachment underwent endoscopic Draf II A frontal sinusotomy. Three cases with either lateral and posterior walls of frontal recess and frontal infundibulum attachment or medial and posterior walls of frontal recess and frontal infundibulum attachment underwent Draf II B procedure. Two cases with either posterior wall of frontal recess and frontal infundibulum attachment or medial, lateral and posterior walls of frontal recess and frontal infundibulum attachment underwent Draf III procedure. All patients remain disease free with an average follow-up of 13 months.


CONCLUSIONS
Extensive inverted papilloma (Krouse T3 lesions) can be treated successfully with an endoscopic approach.
Zhang
Luo
L
Department of Otorhinolaryngology Head and Neck Surgery, Affiliated Beijing Tongren Hospital, Capital Medical University. Beijing Institute of Otolaryngology, Beijing 100730, China. luozhang@trhos.com
Han
De-Min
DM
Wang
Cheng-Shuo
CS
Ge
Wen-Tong
WT
Ni
Xin
X
Wei
Yong-Xiang
YX
Li
Yun-Chuan
YC
Zhou
Bing
B
D000328:Adult; D000368:Aged; D004724:Endoscopy; D005260:Female; D005626:Frontal Sinus / Q000473:pathology; D006801:Humans; D007765:Lacrimal Apparatus / Q000473:pathology; D008297:Male; D008875:Middle Aged; D013517:Otorhinolaryngologic Surgical Procedures / Q000379:methods*; D018308:Papilloma, Inverted / Q000473:pathology / Q000601:surgery*; D010255:Paranasal Sinus Neoplasms / Q000473:pathology / Q000601:surgery*; D012189:Retrospective Studies