Endoscopic-Assisted Excision of an Extensive Inverted Papilloma (Krouse Stage IV) through Lateral Rhinotomy Approach: A Case Report

Abstract

Inverted papilloma is a benign epithelial growth arising from the Schneiderian mucosa with a tendency to grow into the underlying stroma. The etiology remains obscure but its tendency for an association with malignancy makes it an important entity important for the surgeon. We present a case report of an extensive inverted papilloma (Krouse stage IV). The tumour involved entire right side nasal cavity extending to the vestibule, extended to the orbit and also intracranially (though extradural) through the frontal and ethmoid sinuses. This extensive tumour was removed by a combined (lateral rhinotomy plus endoscopic) approach and obviated the need for external approach to frontal sinus as well as extended lateral rhinotomy. Thus, even for extensive tumours using the endoscope as an adjunct aids in complete tumour removal and prevents additional morbidity to the patient.