A case of recurrent sphenoid sinus inverted papilloma excision by the transpterygopalatine fossa technique

Abstract

Inverted papilloma arising from the sphenoid sinus is rare. The first choice of treatment for inverted papillomas of the nasal and paranasal sinuses is complete surgical excision of the tumor. The sphenoid sinus is anatomically surrounded by important structures, such as cranial nerves II-VI, the internal carotid artery, and the cavernous sinus. Excising tumors without damaging these structures during surgery is crucial. Furthermore, very few reports have described the procedure for excising tumors that extend into the lateral fossa of the sphenoid sinus. We herein report a 53-year-old woman with inverted papillomas occurring simultaneously in the right maxillary and left sphenoid sinuses who underwent endoscopic sinus surgery (ESS). One year and four months after the initial surgery, the papilloma that extended to the lateral fossa of the left sphenoid sinus was excised by ESS via the left pterygopalatine fossa. If possible, an inverted papilloma extending to the lateral fossa of the sphenoid sinus should be excised using ESS. However, depending on the nature of the tumor, removal via the pterygopalatine fossa should also be considered.