A New Approach Using the "Transseptal Access with Crossing Multiple Incisions" Method for Tumours Occupying the Nasal Cavity: A Case of Intraosseous Haemangioma

Abstract

External incision for en bloc resection of tumours formed at the anterior portion of the nasal cavity and occupying the cavity is an extremely invasive procedure that can result in nerve damage and facial deformation. With advancements in devices such as endoscopes and debriders, piecemeal excision methods are now feasible. However, in piecemeal excision, tumour bleeding may cause deterioration of the visual field and make identification of the tumour pedicle difficult, which could result in recurrence. In 2017, a novel endoscopic approach, termed “transseptal access with crossing multiple incisions” (TACMI), was reported; this technique makes a direct approach to the tumour origin possible by tumour transposition across the midline. This method provides a good field of view and working space and allows surgeons to approach the tumour pedicle directly by moving the tumour beyond the midline. Here, we report a case of intraosseous haemangioma, which occupied the nasal cavity, and which was removed en bloc using an endoscopic approach, with good visibility, by implementing the TACMI method.