Endoscopic modified Denkers procedure: A novel approach to benign sinonasal tumors

<p>Deepak Verma</p>

Endoscopic modified Denkers procedure: A novel approach to benign sinonasal tumors

Deepak Verma

BPS Government Medical College for Women, India

: J Otol Rhinol

Abstract

Aim: This study aims at prospective analysis of five patients with sinonasal inverted papilloma who underwent endoscopic resection. Method: Preoperative symptoms, computed tomography, tumor staging, intraoperative findings and surgical outcomes including recurrence were recorded and analyzed. Skull base erosion, intradural or intraorbital extension, extensive frontal sinus involvement, abundant scar tissue due to previous surgery or concomitant presence of squamous cell carcinoma was considered absolute contraindications for a purely endoscopic approach. Results: All patients were followed by periodic endoscopic evaluations. All patients were in stage III of Krouse staging system. All of them underwent endoscopic resection as primary surgical modality with endoscopic dacryocystorhinostomy as the adjunctive procedure. No intraoperative complications were encountered. No recurrences were noted in any of the patients with a mean follow up of 18 months. Conclusion: If preoperative assessment rules out malignancy, endoscopic resection viz endoscopic modified Denker’s procedure is an excellent approach and could be successfully used to achieve complete resection of sinonasal tumor such as inverted papilloma. Sub periosteal dissection in the involved areas and regular follow-up evaluation are the keys for success.