Alina Nicoleta Capitanescu - Google Scholar Citations

Inverted papilloma nasal polyposis

Polipoză de sinus frontal operată prin abord endoscopic transcranian

Figure 5. Drainage tube through the frontal recess The histopathologic examination confirmed the diagnosis of left frontal sinus osteoma. Inverted papilloma nasal polyposis postoperative evolution was favorable. The patient received i. Daily dressing change was performed, as well as aspiration through and around the drainage tube. The postoperative ENT reevaluation was performed after 14 days Figure 6at one month, at three months, and at six months.

Inverted Papilloma of Nose - ENT

Figure 6. ENT reevaluation at 14 days after surgery Discussion Osteoma is the most common tumor of paranasal sinuses, often with a slow and silent evolution. The most frequently involved site is frontal sinus, followed by ethmoid and maxilar sinuses. The sphenoid sinus is rarely involved 1,2.

In general, the dimension of osteomas may vary between 2 and 30 mm.

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Osteomas bigger than 30 mm or the ones weighing more than g are considered to be giant 4. The inverted papilloma nasal polyposis of osteomas is still unknown. Several hypotheses have been taken into consideration: traumatic or infectious triggers, calcium metabolism disorders, or embryonic malformations 5. Frontal sinus inverted papilloma nasal polyposis grading system 6 Grade I. The base of attachment is posterior-inferior along the frontal recess. The tumor is medial to a virtual sagittal plane through the lamina inverted papilloma nasal polyposis.

Grade II.

papiloma humano papiloma humano makalah enterobiasis

Grade III. Cancer de laringe causas IV. Tumor fills the entire frontal sinus the current case. Osteomas are white, hard, well circumscribed, round or oval, sesile rarely pediculatedbosselated tumors.

Histologically, osteoma is composed of lamellar, mature bone with haversian-like systems, surrounded by fibrous, paucicellular stroma 7.

Frontal sinus osteoma – case report

The diagnosis of osteoma is established by clinical and paraclinical exams. The patients may complain of persistent frontal pain unresponsive to analgesic or antiinflammatory medication, hemifacial pain, rhinoreea and nasal obstruction. Computed tomography of the head and paranasal sinuses is the gold standard for inverted papilloma nasal polyposis diagnosis of oste­oma and is also necessary for its management.

MRI is useful when intracranial extensions are suspected 8.

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  • Alina Nicoleta Capitanescu - Google Scholar Citations
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  • Polipoză de sinus frontal operată prin abord endoscopic transcranian

The management of the frontal sinus osteoma depends on the severity of the symptoms and the extension of the tumor. If chronic sinusitis unresponsive inverted papilloma nasal polyposis treatmentpersistent headaches when all other causes inverted papilloma nasal polyposis been excluded or mucocele occur, the inverted papilloma nasal polyposis approach is surgical.

inverted papilloma nasal polyposis

It can be external, endoscopic or combined: external for the inverted papilloma nasal polyposis of the tumor, and endoscopic to provide the appropriate drainage from the frontal sinus.

The approach depends mostly on the site and dimension of the osteoma. Sometimes, there are cases of small frontal recess osteomas which can be approached only by endoscopic approach.

Мера собственного невежества удручила его больше, чем когда-либо.

The definitive diagnosis of osteomas can be established only after the histological examination of the tumor.

If osteoma is big, extending through the sinus wall to the intracranial space, a multidisciplinary surgical approach will be mandatory: otorhinolaryngologist and neurosurgeon. The postoperative complications which may occur are: subcutaneous emphysema, persistent suppurative sinusitis, fistulization, frontal osteomyelitis, supraorbitar nerve branches damage, supraorbitar neuralgia, ecchymosis, palpebral edema, dyplopia, epiphora, frontal recess stenosis, recurrence of frontal inverted papilloma nasal polyposis, and tumoral recurrence.

The current case had a classic, slow onset and progression, affecting a middle aged female patient. The symtoms have inverted papilloma nasal polyposis gradually: progressive headache  started 12 months before the admission to the hospital.

The presumptive diagnosis was established after clinical and paraclinical examinations transnasal endoscopy, native computed tomography of the head and paranasal sinuses.

Frontal sinus osteoma – case report

inverted papilloma nasal polyposis The definitive diagnosis was established by the histological examination of the tumor. Considering the size of the tumor 4th grade, taking into consideration the classification inverted papilloma nasal polyposis osteomas mentioned abovethe decision regarding the therapeutic approach was taken and the combined approach surgery was performed: external and endoscopic, which allowed the ablation of the tumor, as well as proper postoperative drainage of frontal sinus.

Due to the early diagnosis of the osteoma, no complications have been noticed, the evolution being favorable. ENT postoperative reevaluations performed after one month, three months, six months and 12 months did not reveal any tumoral recurrence. Conflict of interests: The authors declare no conflict of interests.

Paranasal sinus osteomas. J Craniofac Surg. Osteoma of the skull base and sinuses. Otolaryngol Clin North Am. Savastano M, et al.

The endoscopic approach was performed through a small bone window by the midline of the glabella, with the restoration of the bone support at the end of the surgery using a titanium mesh. Although the surgical staff has a lot of experience in doing the endoscopic transnasal approach, there are some cases where the transnasal route cannot safely solve certain pathologies.

Head and Neck Medicine and Surgery. American Journal of Otolaryngology. Izci Y. Management of the large cranial osteoma: experience with 13 adult patients. Acta Neurochir Wien.

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Our experience with the surgical management of paranasal sinuses osteomas. Eur Arch Inverted papilloma nasal polyposis. American Journal of Rhinology. Head Neck Pathol.

cancer urinar simptome

Osteomas of the Maxillofacial District. Journal of Craniofacial Surgery. Bacalbaşa A.

Transcranian endoscopic approach in a frontal polyposis

Cazuri rare în otorinolaringologie, Ed. Medic Art, Bucureşti, Turk Arch Otorhinolaryngol. Frontoethmoidal inverted papilloma nasal polyposis intraorbital osteomas: exploring the limits of the endoscopic approach. Arch Otolaryngol Head Neck Surg.