A prelacrimal approach technique to overcome the limitation of the narrow lacrimal recess

Eur Arch Otorhinolaryngol. 2021 Jun;278(6):1885-1889. doi: 10.1007/s00405-020-06472-z. Epub 2020 Nov 13.

Abstract

Purpose: The distance between the anterior wall of the maxillary sinus and the nasolacrimal duct has been classified into three types by Simmen, in which type I (< 3 mm) is the least feasible for a prelacrimal approach. The aim of our study is to present a surgical technique which overcomes the anatomical limitation of the narrow lacrimal recess (type I) in the management of inverted papilloma in the maxillary sinus.

Methods: Case series.

Results: Eight patients with type I lacrimal recess underwent surgical resection for inverted papilloma in the maxillary sinus via a prelacrimal approach. The technique is described in detail in the article and essentially involves exposure of the nasolacrimal duct using a diamond burr. Complete tumor excision was achieved in all cases through this access, with no significant intra-operative complications.

Conclusions: This prelacrimal approach technique is safe and effective for the management of inverted papilloma in maxillary sinuses with a type I lacrimal recess configuration.

Keywords: Inverted papilloma; Maxillary sinus; Narrow lacrimal recess (type I); Prelacrimal approach.

MeSH terms

  • Endoscopy
  • Humans
  • Intraoperative Complications
  • Lacrimal Apparatus* / diagnostic imaging
  • Lacrimal Apparatus* / surgery
  • Maxillary Sinus / diagnostic imaging
  • Maxillary Sinus / surgery
  • Nasolacrimal Duct* / diagnostic imaging
  • Nasolacrimal Duct* / surgery
  • Papilloma, Inverted* / diagnostic imaging
  • Papilloma, Inverted* / surgery