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VOLUME 14 , ISSUE 2 ( May-August, 2022 ) > List of Articles

RESEARCH ARTICLE

Modified Endoscopic Denker's Approach for Benign Sinonasal Tumors: Our Surgical Experience at a Tertiary Care Center

Deepak Verma, Naveen Sharma, Uma Garg, Ranvir Singh, Shirish Saheewala

Keywords : Endoscopic medial maxillectomy, Inverted papilloma, Sinonasal tumors

Citation Information : Verma D, Sharma N, Garg U, Singh R, Saheewala S. Modified Endoscopic Denker's Approach for Benign Sinonasal Tumors: Our Surgical Experience at a Tertiary Care Center. Int J Otorhinolaryngol Clin 2022; 14 (2):53-55.

DOI: 10.5005/jp-journals-10003-1429

License: CC BY-NC 4.0

Published Online: 17-06-2022

Copyright Statement:  Copyright © 2022; The Author(s).


Abstract

Objective: To study the benefits of modified endoscopic Denker's approach for benign sinonasal tumors. Methods: The study includes prospective analysis of six histopathologically diagnosed patients of sinonasal inverted Papilloma with special emphasis on our experience with modified endoscopic Denker procedure. All patients underwent detailed preoperative evaluation with clinical history, nasal endoscopic examination, and contrast-enhanced computed tomography scan to see the origin and extent of disease. All the relevant findings including patient demographic profile, tumor staging, and surgical outcomes including recurrence were studied. Patients with intracranial or intraorbital extension, extensive frontal sinus involvement, or with sinus malignancy were excluded for this endoscopic approach. All patients were called for periodic endoscopic evaluations in the follow-up period. Results: All six patients operated in the study were in stage III of Krouse staging system. All patients underwent endoscopic surgical resection using modified Denker's approach and endoscopic dacryocystorhinostomy were done as an adjunctive surgical procedure. Intraoperative period was uneventful and no complication was encountered in any of the patients. No recurrence was noted in any of them at the end of follow-up of 18 months. Conclusions: Preoperative evaluation including histopathological biopsy and radiological examination if rules out malignancy, surgical resection using modified endoscopic Denker's approach is an excellent option and could be helpful in achieving complete resection of benign sinonasal tumor such as inverted papilloma. Subperiosteal dissection at the site of involved areas and regular endoscopic evaluation in the follow-up period are the keys for success and thus chances of recurrence can be reduced.


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  1. Myers EN, Fernau JL, Johnson JT, et al. Management of inverted papilloma. Laryngoscope 1990;100(5):481–490. DOI: 10.1288/00005537-199005000-00008.
  2. Kramer R, Som ML. True papilloma of the nasal cavity. Arch Otolaryngol 1935;22(1):22–43. DOI: 10.1001/archotol.1935.00640030033003.
  3. Ringertz N. Pathology of malignant tumors arising in the nasal and paranasal cavities and maxilla. Acta Otolaryngol 1938;27(Suppl): 31–42.
  4. Bielamowicz S, Calcaterrra TC, Watson D. Inverting papilloma of the head and neck: the UCLA update. Otolaryngol Head Neck Surg 1993;109(1):71–76. DOI: 10.1177/019459989310900113.
  5. Roland DE. Inverted papilloma of the nose and paranasal sinuses in childhood and adolescence. Laryngoscope 2009;95(1):17–23. DOI: 10.1288/00005537-198501000-00007.
  6. Sauter A, Matharu R, Horman K, et al. Current advances in the basic research and clinical management of Sinonasal inverted papilloma. Oncol Rep 2007;17(3):495–504. PMID: 17273725.
  7. Wormald PJ, Ooi E, Van Hasselt CA, et al. Endoscopic removal of sinonasal inverted papilloma including endoscopic medial maxillectomy. Laryngoscope 2003;113(5):867–873. DOI: 10.1097/00005537-200305000-00017.
  8. Sautter NB, Citardi MJ, Batra PS. Minimally invasive resection of frontal recess/sinus inverted papilloma. Am J Otolaryngol 2007;28(4): 221–224. DOI: 10.1016/j.amjoto.2006.09.003.
  9. Waitz G, Wigand ME. Results of endoscopic sinus surgery for the treatment of inverted papillomas. Laryngoscope 1992;102:917–922. DOI: 10.1288/00005537-199208000-00012.
  10. Kamel RH. Conservative endoscopic surgery in inverted papilloma. Preliminary report. Arch Otolaryngol Head Neck Surg 1992;118(6): 649–653. DOI: 10.1001/archotol.1992.01880060099020.
  11. Krouse JH. Development of a staging system for inverted papilloma. Laryngoscope 2000;110(6):965–968. DOI: 10.1097/00005537-200006000-00015.
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