Инвертированная папиллома клиновидной пазухи

Abstract

Inverted papilloma of the nasal cavity and paranasal sinuses is a benign tumor, accounting for approximately 0.4 to 7% of all sinonasal neoplasms. An isolated lesion of one paranasal sinus is a rare disease, it occurs in 5% of cases. Female patient T., 57 years old, with the complaints of violation of nasal breathing on the right, constant nasal congestion of the right half of the nose, periodic congestion of the right ear and headache on the affected side, she was admitted for planned surgical treatment to ENT deprtment of Clinical Medical Center of A. I. Yevdokimov Moscow State University of Medicine and Dentistry for scheduled surgical treatment. The listed symptoms have been observed for about 10 years. Computed tomography showed a subtotal opacification of the right sphenoid sinus with spreading into the nasal cavity and nasopharynx. Preliminarily performed tumor biopsy with the following histological examination established an inverted papilloma. A transnasal endoscopic approach to the posterior sections of the nasal cavity was performed with the removal of the entire front and part of the lower walls of the right sphenoid sinus, removal of the tumor and wide dissection of the mucosa of the posterior sections of the nasal cavity and right sphenoid sinus in order to remove all possible loci of the primary focus. Planning of transnasal surgery begins with establishment a clinical diagnosis, confirmed in doubtful cases by the results of histological examination, analysis of the results of the necessary imaging method, and the selection of an adequate approach that contributes to complete dissection of the pathological formation and safe controlled surgery in aspects of blood loss and the injury of critical neurovascular structures within the least possible time period.