Inverted Papilloma Resection: Endoscopic Medial Maxillectomy in HD

Survey

Indications:

  • Inverted Papilloma (Schneiderian Papilloma)
  • Benign sinonasal neoplasms arising from the lateral nasal wall or maxillary sinus

Highlights:

  • Sinonasal landmarks are identified, including the maxillary sinus ostium, middle & inferior turbinates, and ethmoid roof
  • Attachment of the tumor (stalk) is identified and transected
  • Bulk of the tumor is excised
  • Bone at the base of the tumor (stalk attachment site) is drilled and/or resected in order to clear microscopic disease
  • The entire lateral nasal wall, including the inferior turbinate, is resected
  • At the completion of surgery the maxillary sinus and nose should be a common cavity, enhancing postoperative surveillance for tumor recurrence

Keep in mind:

  • If the nasolacrimal duct is transected during surgery, a lacrimal stent is placed to decrease the likelihood of postoperative epiphora. This stent is removed one week after surgery.
  • Postoperative nasal saline irrigations are helpful to clear crusts which commonly form after this surgery