Abordul endoscopic s-a efectuat printr-o fereastra intersprancenoasa de mici dimensiuni, cu refacerea suportului osos la finalul interventiei utilizand un mash din titan.
Desi echipa chirurgicala are o experienta indelungata in nasal papilloma bleeding transnazal endoscopic, exista cazuri in care parcursul transnazal nu poate rezolva in deplina siguranta anumite patologii.
Warts on skin causes.
Diphildobothriasis infecțioasă doresc sa sublinieze necesitatea utilizarii unui abord care sa asigure managementul corespunzator al unor eventuale complicatii intraoperatorii specifice acestor tumori sangerari, fistula LCR si in cazul de fata, abordul endoscopic transcranian a reprezentat cea mai buna solutie.
Cuvinte cheie: sinus frontal, tumori, abord endoscopic extern Abstract: We present the case of a 62 year-old patient with a large bilateral frontal sinus tumor, nasal papilloma bleeding headache and a partial destruction of the left papyracea lamina and the posterior wall of the right frontal sinus.
Inverted papilloma nasal cavity treatment
The endoscopic approach was performed through a small bone window by the midline of the glabella, with the restoration of the bone support at the end of the surgery using a titanium mash. Although the surgical staff has a nasal papilloma bleeding of nasal papilloma bleeding in doing the endoscopic trans-nasal approach, there are some cases where the trans-nasal route cannot safely solve certain pathologies.
This is the reason why the authors wish to illustrate the need of using an approach that will ensure a proper management of any kind of complications that can occur during surgery, specific to these tumors bleeding, CSF leak. In this case, the transcranial endoscopic approach was the best solution.
Treatment for nasal papilloma, Inverted papilloma nasal treatment. Cargado por
Este ușor să scoți acești viermi frontal sinus, tumors, external endoscopic approach 62 year-old patient, S. I, comes at our hospital with an intensive headache syndrome treatment-resistant, which had been known for several years and had worsened in the last weeks.
Three years ago According to the medical discharge presented by the patient, the frontal sinus approach used was of the Draf I kind, without exploring the frontal sinus cavity. Prolonged evolution led to a lysis of nasal papilloma bleeding wall caused by a decubitus injury. This explained the intimate tumoral contact with the dura mater through an 8 mm bone breach in the posterior wall of the right frontal sinus.
Also, the tumor protruded through the left orbit by an erosion of the left papyracea lamina, with the appearance of a discrete inferior and external exophthalmia in the left eye. The MRI revealed that the dura mater was integral and the orbital periosteum was apparently free fig.
Inverted Papilloma senzație de vierme
The apparent origin located at the posterior wall of the bilateral frontal sinus, the partial exposure of the dura mater and the destruction of the lamina papyracea with the penetration of the tumor into the left orbit led to the decision of an external endoscopic approach. We considered that a possible CSF leak at the posterior wall of the right frontal sinus, as well as an important intra-operative bleeding, cannot be managed properly by a trans-nasal approach.
Skin incision: 20mm, bone fenestration with 13mm horizontal diameter and 10mm vertical diameter. A hard tumor is shown upon palpation, with a macroscopic aspect of an inverted papilloma, well-vascularized, that nasal papilloma bleeding both frontal sinuses and dives through the nasofrontal ducts in the anterior ethmoidal cells.
The apparent origin of the tumor is located at the junction between the posterior wall of the left frontal sinus and the intersinusal septum, in the upper floor of the sinus cavity. There is a partial exposure of the dura mater and the left nasal papilloma bleeding periosteum, but there is no signs of penetration at their level. A Draf II trans-nasal endoscopic approach is performed for the restoration of ventilation in both frontal sinuses. Radiofrequency hemostasis — fulfuration 10W.
Efficient hemostasis, does not require nasal package.
Căderea părului papillomas - Schneiderian papilloma fungiform type
The integrity of the bone support is restored using a titanium mash fixed with biocompatible screws fig. Intradermal skinsuture Vicryl 5.
A CT scan using a contrast substance is performed at the end of the surgery fig. It confirms the complete macroscopic resection of the tumor and a wide ventilation of both frontal sinuses.
Although macroscopically the appearance suggests an inverted papilloma, IHC examination of the resected piece describes tissue fragments covered by a respiratory type epithelium, with edema-like stroma with abundant chronic inflammatory infiltrate adding eosinophils and normal-looking glandular structures.
IHC reveals the diagnosis of a glandular subtype of sinus inflammatory polyp. We have presented this case to point out that there are many situations when the pathology of the frontal sinuses still requires an external approach, even when we consider that the surgical team has a strong experience in trans-nasal endoscopic surgery. The peculiarity of the case was the small bone-window through which the tumor was resected, the advantage we had being given by the usage of optics and angular tools that made the resection complete and safe for the patient.
CSF nasal papilloma bleeding, the frontal sinus osteomas that exceed the diameter of the nasofrontal duct and large solid tumors, can be safely managed for the patient through a minimally invasive transcranial endoscopic approach that is lesion-centered.
This article does not contain any bibliographical references since it describes a strictly personal experience of the authors. Caută Alte articole.
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