Endoscopic surgery in hemangiomas of paranasal sinuses and nasal cavity

Abstract

Objectives: To determine the possibility of performing complete resections of rhinosinusal hemangiomas greater than 2cm treated by an endonasal approach assisted with endoscopes. Study design: Descriptive, retrospective Methods: We analyzed the clinical histories of all adult patients who underwent an endonasal approach with endoscopes, for having hemangiomas of the nasal cavity and paranasal sinuses in the Italian Hospital of Buenos Aires, between June 2006 and December 2016. We excluded patients with hemangiomas who were less than 18 years old, with small tumors (less than 2 cm), vascular malformations, and those who underwent surgical procedures performed externally. The surgeries were performed under general anesthesia, with endoscopes of 0° and 30°, conventional surgical instruments were used for rhinosinusal endoscopic surgery. The follow-up was performed by nasal endoscopy, computed tomography and/or magnetic resonance with contrast. Results: Four patients were treated for nasal cavity (1/4) and paranasal sinuses (3/4) hemangiomas through an endonasal approach with endoscopes. There were no complications. The follow-up was greater than 5 years in two, 2 years in one and 1 year in another patient. No recurrences were detected. Conclusión: Trans-nasal surgery assisted with endoscopes of paranasal sinus and nasal cavity hemangiomas greater than 2 cm in adults, allowed perform complete resections in 100% of treated patients. In extensive hemangiomas and when it was not possible to detect the site of vascular tumor implantation, it was important to previously devascularize the lesion by preoperative embolization and cauterization of the vascular pedicles before resecting the tumor.

Untitled

“…The combination of estrogen and progesterone would increase venous distensibility, and stimulate endothelial proliferation, although no receptors for these hormones have been detected in 21 lobulated capillary hemangiomas. [7][8][9][10] In another study, 2 recurrences were reported in 37 patients treated with endonasal surgery with endoscopes. 3 In all the studies referred to above, they used local anesthesia to operate patients with smaller hemangiomas, which originated in the nasal cavity and in which they identified the implantation site.…”