Transnasal endoscopic approach with powered instrumentation for treating squamous papilloma in the nasopharyngeal surface of the soft palate

Jh, Lee; Yo, Lee; Ch, Lee; Cho, Kyoo-Sung

doi:10.1017/s0022215112003167

Cited by 3 publications

(9 citation statements)

References 12 publications

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“…Tumors arising from the DASP are rare and there few studies have discussed the technical aspects of DSAP tumor resection 6–8 . The transoral 6 and transnasal 7,8 approaches are usually adopted for tumor resection.…”

Section: Discussionmentioning

confidence: 99%

“…The angled nasal endoscope is often used together with specialized instruments such as a microdebrider 8 or coblator 7 for transnasal surgery. In these reported cases, multiple surgeries were often needed because of tumor recurrence 7,8 . These results indicate the difficulty of DASP tumor resection with sufficient margins and that incomplete resection of DASP tumors could result in recurrence.…”

Section: Discussionmentioning

confidence: 99%

“…Tumors arising from the DASP are rare and there few studies have discussed the technical aspects of DSAP tumor resection. [6][7][8] The transoral 6 and transnasal 7,8 approaches are usually adopted for tumor resection. The angled nasal endoscope is often used together with specialized instruments such as a microdebrider 8 or coblator 7 for transnasal surgery.…”

Section: Discussionmentioning

confidence: 99%

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Transoral Removal of Tumors of the Dorsal Aspect of the Soft Palate: A Technical Note

et al. 2021

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Transoral Removal of Tumors of the Dorsal Aspect of the Soft Palate: A Technical Note

et al. 2021

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“…RRP is caused by human papillomavirus (HPV) types 6 and 11 and most commonly occurs in the laryngotracheobronchial system. However, in rare instances (∼3% of cases), RRP involves the nasopharynx . Due to their location, nasopharyngeal papillomas may be challenging to visualize and access surgically.…”

Section: Introductionmentioning

confidence: 99%

Nasopharyngeal papillomas treated with CO₂ laser and human papillomavirus vaccination

et al. 2017

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This case report describes the use of CO2 laser and quadrivalent human papillomavirus (HPV) vaccination in two patients with nasopharyngeal HPV11-positive recurrent respiratory papillomas (RRP). These patients initially underwent CO2 laser excision but developed recurrent lesions and underwent HPV vaccination as adjunct therapy. The recurrent lesions shrank after vaccination and were again excised with CO2 laser. Subsequently, these patients had no recurrence of lesions on long-term follow-up at 33 months or 6 years after surgery. Thus, in patients with nasopharyngeal RRP, resection with CO2 laser, and HPV vaccination as adjunct therapy should be considered in HPV11-associated cases. Laryngoscope, 127:2279-2281, 2017.

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“…Other authors have described endoscopic approach as a useful technique for the resection of midline tumors. 3 Although this may help in the operating room to ensure the correct margin of the resection, we consider it is difficult to accomplish the entire resection with free margins. The Le Fort approach, however, allows the direct visualization of the margins as the osteotomy is performed and warrants a better resection.…”

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confidence: 99%

Le Fort I Approach for Midline Tumors of the Palate

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et al. 2015

Craniomaxillofacial Trauma & Reconstruction

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Hard palate tumors may arise in the midline without affecting the alveolar ridge. In this cases a Brown class IA maxillectomy must be performed to carry out the tumor resection, preserving the dental arcade and therefore achieving better functional results. 1 The way this maxillectomy is executed is variable depending on the tumor size and the surgeon's preferences. In those tumors developing as endophytic masses with extension into the nasal cavity, it may be difficult to guarantee a deep tumor-free margin if the resection is made through a palatine approach. In this situation, a Le Fort I downfracture approach simplifies the surgical procedure improving the visualization of the entire tumor and the nearby structures, such as the descending palatine artery. In this manner, a complete tumor resection is guaranteed and the potential complications are reduced. At the same time, this procedure enables the reconstruction with a temporal muscle flap that otherwise could not be accomplished in a dentate patient. 2 Once in the operating room, the kind of intubation should be individualized. For unilateral tumors, intranasal intubation is preferred to improve the intraoral visualization and facility tumor resection. Submental intubation represents an effective alternative especially with tumors affecting both nostrils. This technique places the endotracheal tube away from our surgical field and improves the tumor visualization.In the surgical technique, first, a free margin is delimitated on the palatine mucosa reaching the bone layer and a palatine osteotomy is done using an oscillating saw (►Fig. 1). Next, a vestibular maxillary approach is done and microplates are fixed at both sides of the maxilla to guarantee the correct reposition of the maxilla at the end of the procedure. Screws and microplates are removed and a Le Fort I osteotomy is performed. This represent the most critical point of the approach and attention must be directed to the piriform aperture, lateral nasal walls, and the septum in order to make the cuts without entering into the tumor. Preoperative imaging is crucial to determine the intranasal extension of the tumor and decide the level of the Le Fort osteotomy (►Fig. 2). Vertical extension of the tumor determines the most limiting factor and tumors with high intranasal extension may not be candidates for this kind of approach, as the risk of tumor disruption is higher in these cases.Other authors have described endoscopic approach as a useful technique for the resection of midline tumors. 3 Although this may help in the operating room to ensure the correct margin of the resection, we consider it is difficult to accomplish the entire resection with free margins. The Le Fort approach, however, allows the direct visualization of the margins as the osteotomy is performed and warrants a better resection. Instead of endoscopic assistance, intraoperative Keywords ► midline palatal tumors ► maxillectomy ► Le Fort I approach ► temporal muscle flap AbstractMidline tumors of the palate may represent a challe...

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Transnasal endoscopic approach with powered instrumentation for treating squamous papilloma in the nasopharyngeal surface of the soft palate

Cited by 3 publications

References 12 publications

Transoral Removal of Tumors of the Dorsal Aspect of the Soft Palate: A Technical Note

Transoral Removal of Tumors of the Dorsal Aspect of the Soft Palate: A Technical Note

Nasopharyngeal papillomas treated with CO₂ laser and human papillomavirus vaccination

Le Fort I Approach for Midline Tumors of the Palate

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Transnasal endoscopic approach with powered instrumentation for treating squamous papilloma in the nasopharyngeal surface of the soft palate

Cited by 3 publications

References 12 publications

Transoral Removal of Tumors of the Dorsal Aspect of the Soft Palate: A Technical Note

Transoral Removal of Tumors of the Dorsal Aspect of the Soft Palate: A Technical Note

Nasopharyngeal papillomas treated with CO2 laser and human papillomavirus vaccination

Le Fort I Approach for Midline Tumors of the Palate

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Product

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Nasopharyngeal papillomas treated with CO₂ laser and human papillomavirus vaccination