Maxilectomia maxilară medială pentru papilomul inversat

What is benign papilloma, Traducere "papilloma" în română

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The procedure implies surgical excision of the lateral nasal wall and ethmoid sinus. This technique is aided by the usage of adequate instruments, such as 0° and 70° scopes and angulated surgical in­struments, which allow the complete visualization and access to the maxillary sinus.

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The authors present, as an endoscopic surgical atlas, step by step, the surgical procedure for endoscopic approach of inverted papilloma, in order to reach a complete tumor removal without any leftovers.

Keywords medial maxillectomy, inverted papilloma, endoscopic sinus surgery Rezumat Tehnica maxilectomiei mediale reprezintă standardul de aur în tratamentul chirurgical al papilomului inversat, deoarece oferă o expunere adecvată a peretelul nazal lateral şi a sinusului maxilar. Intervenţia include excizia chirurgicală a peretelui nazal lateral şi a sinusului etmoidal. Această tehnică este posibilă prin folosirea instrumentarului adecvat, a tijelor de 0° şi 70° şi a instrumentelor chirurgicale angulate, care permit vizualizarea şi accesul complet spre sinusul maxilar.

În ceea ce privește infecția cu virusul HPV la bărbați, aceștia sunt mult mai predispuși la infectare pe cale orală, prin sex oral neprotejat. La bărbat negii au localizare frecventa pe partea superioara a organului genital, pe suprafața scrotului sau anusului. Bărbații constituie un rezervor al virusului, atât prin patologia benignă cât și malignă asociată cu virusul HPV. Infecția cu HPV la bărbați este în general sub-clinică, ceea ce va rezulta într-un număr mare de purtători asimptomatici. În schimb, pentru diagnosticul negilor se poate efectua un examen vizual al ariei what is benign papilloma de către un medic specialist, iar în cazul în care se consideră necesar se poate identifica prezența virusului HPV și a genotipului prin prelevare de secreție uretrala.

Autorii prezintă, ca un atlas de chirurgie endoscopică, paşii acestei tehnici chirurgicale de abord endoscopic al papilomului inversat, în vederea exciziei complete a tumorii, fără nicio restanţă.

Cuvinte cheie maxilectomie medială papilom inversat chirurgie sinuzală endoscopică Introduction Inverted papilloma represents an invasive, unilate­ral, benign tumoral mass, which has its origin in the nasal mucosa and presents a risk of malignancy.

Maxilectomia maxilară medială pentru papilomul inversat

It is most commonly located on the lateral nasal wall, extended to the maxillary and ethmoid sinus 1. When it has its origin in the maxillary sinus, the elected technique is represented by endoscopic medial maxillectomy. Medial maxillectomy aims what is benign papilloma enable the access to the maxillary sinus, superior to the combined middle and inferior meatus approach. In the last decades, with the development of endoscopic and imagistic techniques, the endoscopic approach replaced the external procedures, as it presents similar success what is benign papilloma, lower morbidity and better esthetic outcomes for the patient 2.

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Also, endoscopic approach was proven to allow the better evaluation of nasal mucosa. The indications for endoscopic medial maxillectomy include inverted papilloma, nasopharyngeal angiofibroma and pterygomaxillary fossa pathology 3.

The diagnostic protocol depends on a computed tomography, which illustrates the extension and place of attachment of the tumor.

Human what is benign papilloma virus HPV infection Infectarea cu virusul uman papilloma HPV This concerns in particular seasonal influenza, childhood vaccination and human papilloma virus HPV [financing mechanism: Call for proposals and workshops] Acestea se referă în special la gripa sezonieră, vaccinarea copiilor și virusul papiloma uman HPV [Mecanismul de finanțare: Cerere de propuneri și ateliere] Cervical cancer is caused by high-risk types of the Human Papilloma Virus HPV. Infection by human papilloma virus plays an important role in the development of genetic changes that initiate cancer development. Infecţia cu virusul uman papilloma joacă un rol important în dezvoltarea schimbărilor genetice care iniţiază apariţia cancerului.

This image shows the left maxillary sinus completely occupied by a tumoral mass, extended to the left nasal fossa, hyperostosis of the maxillary sinus walls and an anterior bony thickening, representing the origin of the tumor Figure 1. Figure 1. CT image, coronal section, what is benign papilloma complete blockage of the maxillary sinus, hyperostosis and tumoral origin arrow The first surgical step includes antero-posterior ethmoidectomy, with the excision of the tumor from this level and from the middle meatus.

We used a piece-meal resection, using bipolar electrocoagulation for hemostasis Figure 2. Figure 2.

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Intraoperative aspect of ethmoidectomy with tumor excision After ethmoidectomy and clearing of the middle meatus, the resection of the inferior turbinate and sinonasal wall is performed.

This technique allows a complete resection of the tumor and a good visualisation of the maxillary sinus extensions Figure 3.

Figure 3. Endoscopic resection of the inferior turbinate and lateral nasal wall Medial maxillectomy offers an optimal access to the maxillary what is benign papilloma, with the complete resection of the tumor and the identification of the tumor origin.

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It represents the key point of tumor resection in order to avoid any leftovers Figure 4. Figure 4. The identification of the tumor origin using the 70° scope The deperiostation of the tumor attachment is required, as it lowers the risk of recurrence.

We can succeed testicular cancer join military this procedure using an angulated curette Figure 5 or an angulated diamond burr, depending on the position of the bony stalk or hyperostosis.

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Figure 5. The deperiostation of tumor origin Final image of the widely opened medial maxillectomy ostium and resorbable sponge applied in the maxillary sinus. This procedure does not require the usage of a hemostatic sponge Figure 6.

Figure 6. Final image with resorbable sponge applied Conclusions Inverted papilloma is a benign tumor what is benign papilloma recurrence and malignancy potential.

Endoscopic medial maxillectomy for inverted papilloma

Recurrence is in fact a tumoral residue. The endoscopic medial maxillectomy is the elected technique for complete tumoral what is benign papilloma and ensures a superior approach to the maxillary sinus and also lowers the risk of recurrence.

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Conflict of interests: The authors what is benign papilloma no conflict of interests. Sinonasal inverted papilloma: A case report and mini review of histopathological features. Journal of Oral and Maxillofacial Pathology.

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Cunningham K, Welch K. Endoscopic medial maxillectomy. Operative Techniques in Otolaryngology. Transnasal endoscopic medial maxillectomy for inverting papilloma.

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The Laryngoscope.