Korean J Otorhinolaryngol-Head Neck Surg.  2021 Mar;64(3):161-168. 10.3342/kjorl-hns.2020.00031.

Comparison of Surgical Outcomes for Treatment of Maxillary Sinus Inverted Papilloma: Endoscopic Prelacrimal Recess Approach versus Caldwell-Luc Approach

• Park YJ
• Park BW
• Suh TK
• Kim MR
• Kim SY
• Kim SH
• Baek MJ
• Kang M
• Kim YW

• KMID: 2513934
• DOI: http://doi.org/10.3342/kjorl-hns.2020.00031

Abstract

Background and Objectives
Endoscopic prelacrimal recess approach (PLRA) was introduced to treat maxillary sinus inverted papilloma (IP) without sacrificing the inferior turbinate and nasolacrimal duct. This study aimed to compare surgical outcomes of prelacrimal recess approach with the conventional Caldwell-Luc approach (CLA) to remove IP of maxillary sinus and to evaluate the usefulness of the PLRA.
Subjects and Method
We retrospectively reviewed medical records of 51 patients who were treated 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 surgery combined with either CLA (n=8) or PLRA (n=8). Demographic data, surgical technique, site of IP origin, intra- and postoperative complications, duration of follow-up, recurrence rate and pathologic diagnosis were reviewed.
Results
IP was the pathologic diagnosis for all 16 cases. Gross total removal was achieved in all cases. The mean follow-up period was 20.1 months in CLA group and 12.5 months in PLRA group. There was one case of massive bleeding during operation requiring transfusion and postoperative ICU care in CLA group. On postoperative follow-up, two patients from the CLA group had recurrence during the follow-up period. One patient had numbness around the gingival area, another patient had transient wound dehiscence, and another had persistent oro-antral fistula. In PLRA group, one patient had periorbital swelling after blowing nose; otherwise, no other patient from the PLRA group developed subjective complaints after surgery.
Conclusion
Endoscopic prelacrimal recess approach showed lower complication rates and recurrence rates compared to CLA. PLRA is a safe and effective method for the excision of primary maxillary sinus IP.

Keyword

Maxillary sinus; Inverted papilloma; Minimally invasive surgical procedures; Prelacrimal recess approach