Combined endonasal and eyelid approach for management of extensive frontal sinus inverting papilloma

Monirah Albathi, Murugappan Ramanathan, Andrew P. Lane, Kofi D.O. Boahene

Research output: Contribution to journalArticleResearchpeer-review

4 Citations (Scopus)

Abstract

Objectives: Sinonasal inverting papilloma (IP) is a benign but locally aggressive mucosal neoplasm with a high recurrence rate. Extension into the frontal sinus presents surgical challenges for endonasal resection. This study presents an orbitofrontal approach for managing extensive IP. Study Design: Case series. Methods: Four patients seen between 2012 and 2016 with biopsy-proven IP with lateral frontal sinus extension underwent a combined endonasal and transpalpebral approach for tumor resection. Patient demographic data, preoperative characteristics, imaging, and follow-up data were compiled through retrospective chart review. Patients were selected for this approach when the tumor extended to the posterior frontal sinus wall, lateral frontal sinus recess, and orbit. Tumors were first approached endonasally until the frontal recess was reached. A Draf IIB or Draf III procedure was then performed to gain better exposure. Orbitofrontal exposure was achieved through an upper eyelid incision. Miniorbitofrontal craniotomy window was designed based on tumor location. Resection of the frontal and orbital extension was enhanced by endoscopic-assisted dissection through the orbitofrontal window. Results: The transpalpebral approach provided access to all walls of the ipsilateral frontal sinus, the intersinus septum, and the medial aspect of the contralateral sinus. Complete tumor resection was achieved in all patients. There were no orbital complications, no visible eyelid asymmetry or scarring, and all patients had preserved forehead sensation. There were no recurrences on follow-up. Conclusion: Combining a transpalpebral orbitofrontal craniotomy with the endonasal approach allows complete resection of invasive IP with extension into the frontal sinus. This is achieved with great cosmetic results. Level of Evidence: 4. Laryngoscope, 128:3–9, 2018.

Original languageEnglish
Pages (from-to)3-9
Number of pages7
JournalLaryngoscope
Volume128
Issue number1
DOIs
Publication statusPublished - 1 Jan 2018

Fingerprint

Frontal Sinus
Papilloma
Eyelids
Transverse Sinuses
Neoplasms
Craniotomy
Laryngoscopes
Recurrence
Forehead
Orbit
Cosmetics
Cicatrix
Dissection
Demography
Biopsy

Keywords

  • frontal sinus
  • Inverting/inverted papilloma
  • minimally invasive
  • transpalpebral orbitofrontal

Cite this

Albathi, Monirah ; Ramanathan, Murugappan ; Lane, Andrew P. ; Boahene, Kofi D.O. / Combined endonasal and eyelid approach for management of extensive frontal sinus inverting papilloma. In: Laryngoscope. 2018 ; Vol. 128, No. 1. pp. 3-9.
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abstract = "Objectives: Sinonasal inverting papilloma (IP) is a benign but locally aggressive mucosal neoplasm with a high recurrence rate. Extension into the frontal sinus presents surgical challenges for endonasal resection. This study presents an orbitofrontal approach for managing extensive IP. Study Design: Case series. Methods: Four patients seen between 2012 and 2016 with biopsy-proven IP with lateral frontal sinus extension underwent a combined endonasal and transpalpebral approach for tumor resection. Patient demographic data, preoperative characteristics, imaging, and follow-up data were compiled through retrospective chart review. Patients were selected for this approach when the tumor extended to the posterior frontal sinus wall, lateral frontal sinus recess, and orbit. Tumors were first approached endonasally until the frontal recess was reached. A Draf IIB or Draf III procedure was then performed to gain better exposure. Orbitofrontal exposure was achieved through an upper eyelid incision. Miniorbitofrontal craniotomy window was designed based on tumor location. Resection of the frontal and orbital extension was enhanced by endoscopic-assisted dissection through the orbitofrontal window. Results: The transpalpebral approach provided access to all walls of the ipsilateral frontal sinus, the intersinus septum, and the medial aspect of the contralateral sinus. Complete tumor resection was achieved in all patients. There were no orbital complications, no visible eyelid asymmetry or scarring, and all patients had preserved forehead sensation. There were no recurrences on follow-up. Conclusion: Combining a transpalpebral orbitofrontal craniotomy with the endonasal approach allows complete resection of invasive IP with extension into the frontal sinus. This is achieved with great cosmetic results. Level of Evidence: 4. Laryngoscope, 128:3–9, 2018.",
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Combined endonasal and eyelid approach for management of extensive frontal sinus inverting papilloma. / Albathi, Monirah; Ramanathan, Murugappan; Lane, Andrew P.; Boahene, Kofi D.O.

In: Laryngoscope, Vol. 128, No. 1, 01.01.2018, p. 3-9.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Combined endonasal and eyelid approach for management of extensive frontal sinus inverting papilloma

AU - Albathi, Monirah

AU - Ramanathan, Murugappan

AU - Lane, Andrew P.

AU - Boahene, Kofi D.O.

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N2 - Objectives: Sinonasal inverting papilloma (IP) is a benign but locally aggressive mucosal neoplasm with a high recurrence rate. Extension into the frontal sinus presents surgical challenges for endonasal resection. This study presents an orbitofrontal approach for managing extensive IP. Study Design: Case series. Methods: Four patients seen between 2012 and 2016 with biopsy-proven IP with lateral frontal sinus extension underwent a combined endonasal and transpalpebral approach for tumor resection. Patient demographic data, preoperative characteristics, imaging, and follow-up data were compiled through retrospective chart review. Patients were selected for this approach when the tumor extended to the posterior frontal sinus wall, lateral frontal sinus recess, and orbit. Tumors were first approached endonasally until the frontal recess was reached. A Draf IIB or Draf III procedure was then performed to gain better exposure. Orbitofrontal exposure was achieved through an upper eyelid incision. Miniorbitofrontal craniotomy window was designed based on tumor location. Resection of the frontal and orbital extension was enhanced by endoscopic-assisted dissection through the orbitofrontal window. Results: The transpalpebral approach provided access to all walls of the ipsilateral frontal sinus, the intersinus septum, and the medial aspect of the contralateral sinus. Complete tumor resection was achieved in all patients. There were no orbital complications, no visible eyelid asymmetry or scarring, and all patients had preserved forehead sensation. There were no recurrences on follow-up. Conclusion: Combining a transpalpebral orbitofrontal craniotomy with the endonasal approach allows complete resection of invasive IP with extension into the frontal sinus. This is achieved with great cosmetic results. Level of Evidence: 4. Laryngoscope, 128:3–9, 2018.

AB - Objectives: Sinonasal inverting papilloma (IP) is a benign but locally aggressive mucosal neoplasm with a high recurrence rate. Extension into the frontal sinus presents surgical challenges for endonasal resection. This study presents an orbitofrontal approach for managing extensive IP. Study Design: Case series. Methods: Four patients seen between 2012 and 2016 with biopsy-proven IP with lateral frontal sinus extension underwent a combined endonasal and transpalpebral approach for tumor resection. Patient demographic data, preoperative characteristics, imaging, and follow-up data were compiled through retrospective chart review. Patients were selected for this approach when the tumor extended to the posterior frontal sinus wall, lateral frontal sinus recess, and orbit. Tumors were first approached endonasally until the frontal recess was reached. A Draf IIB or Draf III procedure was then performed to gain better exposure. Orbitofrontal exposure was achieved through an upper eyelid incision. Miniorbitofrontal craniotomy window was designed based on tumor location. Resection of the frontal and orbital extension was enhanced by endoscopic-assisted dissection through the orbitofrontal window. Results: The transpalpebral approach provided access to all walls of the ipsilateral frontal sinus, the intersinus septum, and the medial aspect of the contralateral sinus. Complete tumor resection was achieved in all patients. There were no orbital complications, no visible eyelid asymmetry or scarring, and all patients had preserved forehead sensation. There were no recurrences on follow-up. Conclusion: Combining a transpalpebral orbitofrontal craniotomy with the endonasal approach allows complete resection of invasive IP with extension into the frontal sinus. This is achieved with great cosmetic results. Level of Evidence: 4. Laryngoscope, 128:3–9, 2018.

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U2 - 10.1002/lary.26552

DO - 10.1002/lary.26552

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VL - 128

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