“TuNa-saving” endoscopic medial maxillectomy: a surgical technique for maxillary inverted papilloma

Fabio Pagella, Alessandro Pusateri, Elina Matti, Irene Avato, Dario Zaccari, Enzo Emanuelli, Tiziana Volo, Diego Cazzador, Leonardo Citraro, Giampiero Ricci, Giovanni Leo Tomacelli

Research output: Contribution to journalArticle

Abstract

The maxillary sinus is the most common site of sinonasal inverted papilloma. Endoscopic sinus surgery, in particular endoscopic medial maxillectomy, is currently the gold standard for treatment of maxillary sinus papilloma. Although a common technique, complications such as stenosis of the lacrimal pathway and consequent development of epiphora are still possible. To avoid these problems, we propose a modification of this surgical technique that preserves the head of the inferior turbinate and the nasolacrimal duct. A retrospective analysis was performed on patients treated for maxillary inverted papilloma in three tertiary medical centres between 2006 and 2014. Pedicle-oriented endoscopic surgery principles were applied and, in select cases where the tumour pedicle was located on the anterior wall, a modified endoscopic medial maxillectomy was carried out as described in this paper. From 2006 to 2014 a total of 84 patients were treated. A standard endoscopic medial maxillectomy was performed in 55 patients (65.4%), while the remaining 29 (34.6%) had a modified technique performed. Three recurrences (3/84; 3.6%) were observed after a minimum follow-up of 24 months. A new surgical approach for select cases of maxillary sinus inverted papilloma is proposed in this paper. In this technique, the endoscopic medial maxillectomy was performed while preserving the head of the inferior turbinate and the nasolacrimal duct (“TuNa-saving”). This technique allowed for good visualization of the maxillary sinus, good oncological control and a reduction in the rate of complications.

Original languageEnglish
Pages (from-to)2785-2791
Number of pages7
JournalEuropean Archives of Oto-Rhino-Laryngology
Volume274
Issue number7
DOIs
Publication statusPublished - Jul 1 2017

Keywords

  • Endoscopic sinus surgery
  • Epiphora
  • Inverted papilloma
  • Maxillary sinus
  • Medial maxillectomy
  • Nasolacrimal duct

ASJC Scopus subject areas

  • Otorhinolaryngology

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    Pagella, F., Pusateri, A., Matti, E., Avato, I., Zaccari, D., Emanuelli, E., Volo, T., Cazzador, D., Citraro, L., Ricci, G., & Tomacelli, G. L. (2017). “TuNa-saving” endoscopic medial maxillectomy: a surgical technique for maxillary inverted papilloma. European Archives of Oto-Rhino-Laryngology, 274(7), 2785-2791. https://doi.org/10.1007/s00405-017-4549-0