title: Preservation of the nasolacrimal duct during endoscopic medial maxillectomy for sinonasal inverted papilloma.
abstract: BACKGROUND
  To assess the efficacy of a new endonasal medial maxillectomy technique (EMM) for the treatment of inverted papilloma (IP).
  
  
  METHODS
  A prospective series of 55 consecutive patients diagnosed with IP between March 2002 and April 2009 were entered into this study. The new surgical technique was applied to tumors arising from the anterior part of the maxillary sinus. After conventional EMM, the entire nasolacrimal duct was separated from the bony component of the nasolacrimal canal and preserved. Schirmer`s test and a visual analog scale (VAS) score were used to assess the lacrimal duct function after surgery.
  
  
  RESULTS
  Ten of the 55 patients underwent the new surgical procedure. All patients were categorized with stage T3 or T4 tumors. No patients suffered tumor recurrence. There was no difference in lacrimal duct function between the diseased side and healthy side of the nasolacrimal duct. The mean VAS score was 2.8/100.
  
  
  CONCLUSIONS
  This new surgical technique preserves the whole length of the nasolacrimal unit. It also offers several advantages including good visualization, nasolacrimal function after surgery and fewer adverse effects such as facial numbness and epiphora.
authors: Department of Otolaryngologyand Head and Neck Surgery, Hokkaido University Graduate School of Medicine, Sapporo, Japan.
authors: Yuji
authors: Y
authors: Nakamaru
authors: Yasushi
authors: Y
authors: Furuta
authors: Dai
authors: D
authors: Takagi
authors: Nobuhiko
authors: N
authors: Oridate
authors: Satoshi
authors: S
authors: Fukuda
mesh_terms: D000328:Adult; D000368:Aged; D004724:Endoscopy; D005260:Female; D006801:Humans; D007766:Lacrimal Apparatus Diseases / Q000209:etiology; D008297:Male; D008443:Maxillary Sinus / Q000473:pathology / Q000601:surgery*; D008444:Maxillary Sinus Neoplasms / Q000175:diagnosis / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D008875:Middle Aged; D009301:Nasolacrimal Duct / Q000473:pathology / Q000503:physiopathology* / Q000601:surgery*; D013517:Otorhinolaryngologic Surgical Procedures / Q000009:adverse effects / Q000379:methods / Q000534:rehabilitation / Q000592:standards; D010147:Pain Measurement; D018308:Papilloma, Inverted / Q000175:diagnosis / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D019651:Plastic Surgery Procedures; D020127:Recovery of Function; D016896:Treatment Outcome