Department of Otorhinolaryngology, Cairo University, Cairo, Egypt.
Rhinology. 2012 Sep;50(3):262-8. doi: 10.4193/Rhino11.259.
Despite the great progress in endoscopic management of inverted papilloma (IP), involvement of the frontal sinus (FS) remains a challenge.
Six cases of FS IP were assessed. Extent of surgery included simple frontal recess clearance, extended frontal sinusotomy, and modified Lothrop approach. There was no need for adjuvant frontal trephination or an external osteoplastic flap.
FS involvement was observed in 6 out of 119 cases of IP (5%). In one case, IP was originating from the FS and in four it was extending to the FS. The sixth case had a wide origin from the anterior ethmoid and FS. Complete resection of FS IP was achieved in all cases with a single incidence of CSF leak. No recurrence was identified after a follow-up period of an average of 27 months.
FS IP originating outside FS can be delivered transnasally with or without frontal ostium widening and preserving FS mucosa and bone. Inverted papillomata originating from FS proper and those with origin from inside and outside the FS can also be resected tranasnasally after widening of the frontal ostium with removal of surrounding mucosa and drilling or curettage of underlying bone at attachment sites.
尽管内镜下处理内翻性乳头状瘤（IP）取得了很大进展，但额窦（FS）受累仍然是一个挑战。
评估了 6 例 FS IP 病例。手术范围包括单纯额窦切开术、扩大额窦切开术和改良 Lothrop 入路。不需要辅助额部钻孔或外部骨瓣。
在 119 例 IP 病例中，有 6 例（5%）FS 受累。在 1 例中，IP 起源于 FS，4 例延伸至 FS。第 6 例从前筛窦和 FS 广泛起源。所有病例均通过单一的 CSF 漏发生率实现了 FS IP 的完全切除。平均随访 27 个月后，未发现复发。
起源于 FS 外的 FS IP 可以通过经鼻内镜术，或在扩大额窦口的同时保留 FS 黏膜和骨来处理。起源于 FS 本身的内翻性乳头状瘤，以及起源于 FS 内外的内翻性乳头状瘤，也可以在扩大额窦口的同时，切除周围黏膜，在附着部位钻削或刮除下方骨，从而通过经鼻内镜术切除。
