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KMID : 0361020210640030161
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Korean Journal of Otolaryngology - Head and Neck Surgery
2021 Volume.64 No. 3 p.161 ~ p.168
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Comparison of Surgical Outcomes for Treatment of Maxillary Sinus Inverted Papilloma: Endoscopic Prelacrimal Recess Approach versus Caldwell-Luc Approach
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Park Yeong-Jun
Park Byung-Whoo
Suh Tae-Kyung
Kim Mi-Ra
Kim Sang-Yeon
Kim Shin-Hye
Baek Moo-Jin
Kang Myoung-Joo
Kim Yong-Wan
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Abstract
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Background and Objectives : Endoscopic prelacrimal recess approach (PLRA) was introducedto treat maxillary sinus inverted papilloma (IP) without sacrificing the inferior turbinateand nasolacrimal duct. This study aimed to compare surgical outcomes of prelacrimal recessapproach with the conventional Caldwell-Luc approach (CLA) to remove IP of
maxillary sinusand to evaluate the usefulness of the PLRA.
Subjects and Method : We retrospectively reviewed medical records of 51 patients who weretreated in our institution for IP of nasal cavity and sinuses between March 2010 and June 2019.
Twenty patients had maxillary sinus IP. Sixteen patients underwent endoscopic sinus surgerycombined with either CLA (n=8) or PLRA (n=8). Demographic data, surgical technique, site ofIP origin, intra- and postoperative complications, duration of follow-up, recurrence rate andpathologic diagnosis were reviewed.
Results : IP was the pathologic diagnosis for all 16 cases. Gross total removal was achieved inall cases. The mean follow-up period was 20.1 months in CLA group and 12.5 months in PLRAgroup. There was one case of massive bleeding during operation requiring transfusion and postoperativeICU care in CLA group. On postoperative follow-up, two patients from the CLAgroup had recurrence during the follow-up period. One patient had numbness around the gingivalarea, another patient had transient wound dehiscence, and another had persistent oro-antralfistula. In PLRA group, one patient had periorbital swelling after blowing nose; otherwise, noother patient from the PLRA group developed subjective complaints after surgery.
Conclusion : Endoscopic prelacrimal recess approach showed lower complication rates andrecurrence rates compared to CLA. PLRA is a safe and effective method for the excision of primarymaxillary sinus IP.
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KEYWORD
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Maxillary sinus, Inverted papilloma, Minimally invasive surgical procedures, Prelacrimal recess approach
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