Endoscopic modified medial maxillectomy for odontogenic cysts and tumours

Nakayama, Tsugihama; Otori, Nobuyoshi; Asaka, Daiya; Okushi, Tetsushi; Haruna, Shinichi

doi:10.4193/rhin13.134

Cited by 24 publications

(23 citation statements)

References 13 publications

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“…This is the first study reporting the treatment of KCOT with marsupialization using the EMMM approach. With this approach, almost all parts of the maxillary sinus can be reached (Nakayama et al 2012(Nakayama et al , 2014. In our patient, there was inflammation in the KCOT (Fig.…”

Section: Discussionmentioning

confidence: 70%

“…Recently, Nakayama et al (2014) reported a case series of maxillary odontogenic cysts successfully treated with an EMMM approach. All the cases within their series were either cysts or odontogenic tumors confined to the maxillary sinus, i.e.…”

Section: Discussionmentioning

confidence: 99%

“…Subsequently, the same authors reported that this EMMM approach was also useful for treating odontogenic maxillary cysts (Nakayama et al 2014). In all of their cases, the cysts were restricted to the maxillary sinus and could be removed.…”

Section: Introductionmentioning

confidence: 99%

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Minimally Invasive Treatment for Hard Palate-Invading Maxillary Keratocystic Odontogenic Tumor

Nomura

Arakawa

Fujishima

et al. 2015

Tohoku J. Exp. Med.

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Keratocystic odontogenic tumor (KCOT) is one of the benign developmental odontogenic cystic lesions arising from impacted teeth. In comparison to other odontogenic cysts, such as radicular cysts and dentigerous cysts, KCOT is known to be more aggressive and is associated with a relatively high recurrence rate. Traditionally, KCOT has been treated with total resection through sublabial incision. Marsupialization is advocated to reduce surgical invasion. However in all the cases, marsupialization was performed in the oral cavity. With the recent development of appropriate instruments and the endoscopic modified medial maxillectomy (EMMM) technique, which allows preservation of the inferior turbinate and nasolacrimal duct, an exclusive endoscopic approach to KCOT becomes possible. However, when the KCOT invades the hard palate, total resection of the tumor requires subtotal maxillectomy including hard palate. Consequently, as the maxillary sinus connects to the oral cavity, life-long use of a prosthesis becomes mandatory. Here we report a case of a seventeen-year-old female with a hard palate-invading KCOT who was successfully treated with the EMMM approach. The KCOT was fenestrated to the nasal cavity, leading to preservation of the hard palate. The lesion invading the hard palate was found to remain unchanged over one year upon follow-up. The trans-nasal approach with EMMM is a direct, minimally invasive method providing a direct field of view for the treatment of maxillary odontogenic cysts. Marsupialization of the KCOT with the EMMM technique might be a viable treatment option if the maxillary KCOT invades surrounding structures.

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Section: Discussionmentioning

confidence: 70%

Section: Discussionmentioning

confidence: 99%

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Minimally Invasive Treatment for Hard Palate-Invading Maxillary Keratocystic Odontogenic Tumor

Nomura

Arakawa

Fujishima

et al. 2015

Tohoku J. Exp. Med.

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“…In this approach, they submucosally resected the bony inferior turbinate and the inferior part of the uncinate process, then performed EMMA and EIMA to improve their exposure. Nakayama et al [11] published their experience in removing odontogenic cysts and tumors through a medial maxillectomy approach. Sawatsubashi et al [12] reported on endoscopic surgery that combined middle and inferior meatal antrostomies for removing fungal maxillary sinusitis.…”

Section: Discussionmentioning

confidence: 99%

The Rationale for Endoscopic Inferior Meatal Antrostomy

Landsberg

Warman

Margulis

et al. 2019

ORL

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Background: Complete removal of some maxillary sinus pathologies may be challenging. We describe our experience in performing endoscopic inferior meatal antrostomy (EIMA) when approaching certain chronic maxillary sinus disease. Methods: Retrospectively reviewing charts of all patients whose surgery included EIMA between the years 2012 and 2015. EIMA was performed either after routine endoscopic middle meatal antrostomy (EMMA) failed to completely resect the lesion, or as the sole selected approach for specific maxillary pathologies. Results: A total of 56 patients were included in the study. Indications for EIMA included antrochoanal polyps (ACP), maxillary sinus chronic inflammatory disease, maxillary sinus pathology before sinus lift, and odontogenic maxillary sinusitis. In nearly one third of the patients, sinus surgery included only EIMA, of which, the majority were resection of ACP. Follow-up time ranged between 12 and 34 months (mean 14). Residual EIMA opening was variable in size. In the vast majority of our patients, the maxillary sinus cavities were cleared of disease. No major complications and no recirculation were observed in any of the patients. Conclusion: EIMA should be considered for various maxillary sinus pathologies. It provides better access to anteroinferior lesions of the maxillary sinus. EMMA is not mandatory for every maxillary sinus disease.

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“…The TEPM can also provide adequate exposure when dealing with difficult to access areas of the maxillary sinus, such as in the treatment of odontogenic infections involving the alveolar recess on the maxillary sinus floor, 12 during foreign body extraction, and for appropriate removal of recurrent antrochoanal polyps with attachment in the anterior or inferior wall of the sinus. 13 Furthermore, the TEPM is usually an effective procedure for the marsupialization of mucoceles of the maxillary sinus, especially for those eroding the medial maxillary wall with destruction of the inferior turbinate.…”

Section: Indicationsmentioning

confidence: 99%