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Am J Rhinol Allergy. 2018 Nov;32(6):518-525. doi: 10.1177/1945892418801243. Epub 2018 Sep 25.

Resection of Inverted Papilloma of the Maxillary Sinus via a Prelacrimal Recess Approach: A Multicenter Retrospective Analysis of Surgical Efficacy.

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1 Department of Otolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Key Laboratory of Otolaryngology Head and Neck Surgery, Ministry of Education, Beijing, China.
2 Department of Otolaryngology-Head and Neck Surgery, Anhui Provincial Hospital, Anhui, China.
3 Department of Otolaryngology-Head and Neck Surgery, Qilu Hospital of Shandong University, Shandong, China.
4 Department of Otolaryngology-Head and Neck Surgery, Sixth People's Hospital Affiliated to Shanghai Jiaotong University, Shanghai, China.
5 Department of Otolaryngology, Kuang Tien General Hospital, Taiwan.



The intranasal endoscopic prelacrimal recess approach (PLRA) access to all aspects of the maxillary sinus while preserving the inferior turbinate and nasolacrimal duct and its use have been reported in the treatment of many maxillary sinus and lateral skull base diseases.


To retrospectively assess the effectiveness of a 10-year multicenter follow-up for the resection of inverted papilloma of the maxillary sinus (IPMS) via a PLRA.


A total of 71 patients were admitted and underwent IPMS excision via an intranasal endoscopic PLRA from 2003 to 2013. All patients underwent high-resolution computed tomography scanning of the nasal sinus, and some also underwent magnetic resonance imaging examination.


Based on the Krouse staging system, all 71 patients belong to T3 staging. The PLRA was employed to remove IPMS in 71 patients. The postoperative pathological examination of the excised tissue revealed inverted papilloma, and cancerization was identified in 3 patients. The median follow-up time was 37.3 months (range: 13-134 months). Of the 71 patients, reoccurrence was seen in 5 patients (7.04%); 5 patients (7.04%) experienced numbness of the upper lid and the ala of the nose and 4 (5.63%) experienced mild collapse of the ala of the nose.


These multicenter follow-up results demonstrated that the PLRA is a safe and effective method for the excision of primary or recurrent IPMS with lower postoperative complications and recurrent rate.


endoscopic sinus surgery; inverted papilloma; maxillary sinus; prelacrimal recess approach; surgical outcome

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