Apostolos Karligkiotis

Limitations and complications of endoscopic surgery for treatment for sinonasal inverted papilloma: A reassessment after 212 cases

The purpose of this study was to define the optimal surgical strategy for sinonasal inverted papilloma in relation to the site of origin and tumor extent.

Frontoethmoidal and Intraorbital Osteomas Exploring the Limits of the Endoscopic Approach

OBJECTIVE To review our experience with the surgical treatment of frontoethmoidal osteomas, focusing on the osteomas that were either localized laterally in the frontal sinus or showing intraorbital involvement. DESIGN Retrospective evaluation. SETTING Tertiary care center. PATIENTS Patients with symptomatic frontoethmoidal or intraorbital osteomas who had been treated surgically from 1996 through 2011. INTERVENTION Sixty frontoethmoidal osteomas were treated surgically. The lesion involved the far lateral portion of the frontal sinus in 23 cases and the orbital region in 6 cases. In 31 cases, a purely endoscopic approach was performed while a combined procedure was used in 25 patients. In 4 patients, an exclusively external approach was required. MAIN OUTCOME MEASURE No recurrence of osteoma. RESULTS Radical resection was obtained, except in the case of 2 lesions. No osteoma recurrence was observed during a mean follow-up of 72.6 months. CONCLUSIONS The size of the osteoma, far lateral extension of the tumor in the frontal sinus beyond the lamina papyracea, and intraorbital involvement are no longer absolute contraindications for purely transnasal endoscopic resection. What is important is that the surgeon should not be dogmatic but rather be ready to change his or her mind during surgery, shifting to an external approach when required.

Oncocytic Schneiderian papillomas: Clinical behavior and outcomes of the endoscopic endonasal approach in 33 cases

The purpose of this study was to evaluate the clinical behavior of oncocytic Schneiderian papillomas in relation to the rate of malignant transformation and recurrences and to report the long‐term results of the endoscopic endonasal treatment.

Primary orbital eosinophilic angiocentric fibrosis with intranasal extension

Eosinophilic angiocentric fibrosis is a chronic, idiopathic disorder that usually involves the upper respiratory tract and features progressive submucosal perivascular fibrosis of unknown etiology. To our knowledge, only 5 cases of eosinophilic angiocentric fibrosis with primary orbital involvement have been reported.

Endoscopic endonasal orbital transposition to expand the frontal sinus approaches.

Background The management of frontal sinus disease still remains a challenging issue for rhinologists. Although endoscopic frontal sinus surgery has significantly advanced over the past years, there are some conditions in which the external approaches are still necessary. Recently, the increasing experience in endoscopic sinus surgery together with important technologic advancements have allowed expansion of the indications for selected lesions localized more and more lateral into the frontal sinus. Objective The aim of this study was to describe the endoscopic endonasal approach to the far lateral portion of the frontal sinus and to evaluate the outcomes of this technique. Methods A retrospective evaluation was carried out with patients at a single institution, who, from 2004 to 2012, underwent an exclusive endoscopic transnasal approach to the far lateral portion of the frontal sinus at a single institution. The surgical technique included the Draf IIb procedure, a modified Lothrop procedure (Draf III), and endoscopic lateralization of the orbit, differently associated according to the needs of each case. Results Twenty-four patients were eligible for the present study. The lesions included were mucoceles in 9 cases, fibro-osseous lesions in 10 cases, and inverted papillomas in 5 cases. The overall follow-up ranged from 12 to 120 months (mean, 40.6 months). At the time of the last follow-up, no recurrence of disease was observed in the patients treated; in one case of osteoma, a small and stable in size (1 mm) persistent lesion was observed in an asymptomatic patient. One scheduled and one accidental cerebrospinal fluid leak with immediate skull base reconstruction occurred. No intraoperative or postoperative early or late orbital complication was observed in any case. Conclusion The endoscopic endonasal orbital transposition seems to facilitate the endoscopic management of selected far-lateral frontal sinus lesions. However, it is a demanding procedure that requires experience and skill to avoid intraoperative skull base and orbital complications.

A novel endoscopic technique for long‐term patency of cholesterol granulomas of the petrous apex

Cholesterol granulomas (CGs) are rare benigncystic lesions containing cholesterol crystals in a glue-like fluid and are frequently found in the petrous apex(PA) and in the nearby anatomical area. The goldstandard treatment of PA CG counts on its surgicaldrainage and ventilation to prevent recurrence. Differ-ent surgical approaches have been described in the pastto achieve drainage of these lesions, either through lat-eral, or more recently through an endoscopic endonasalcorridor.

Prognostic value of pretreatment peripheral blood markers in paranasal sinus cancer: Neutrophil-to-lymphocyte and platelet-to-lymphocyte ratio.

Pretreatment hematological markers have emerged as prognostic factors for several cancers. The purpose of this study was to present our investigation of the value of neutrophil‐to‐lymphocyte ratio (NLR) and platelet‐to‐lymphocyte ratio (PLR) in predicting recurrence and mortality for patients with primary sinonasal cancers (SNCs).

Endoscopic transnasal approaches to pterygopalatine fossa tumors.

The pterygopalatine fossa (PPF) is a difficult area to access, as it has been traditionally treated by external approaches. The development of endoscopic transnasal approaches enables surgeons to reach this region through a minimally invasive route, reducing the associated morbidity.

Survival outcomes after endoscopic resection for sinonasal squamous cell carcinoma arising on inverted papilloma

Sinonasal inverted papillomas (IPs) can be associated synchronously or metachronously to invasive squamous cell carcinoma (SCC) in 5% to 10% of cases. The purposes of the present study were to analyze the outcomes of patients with sinonasal SCC arising from inverted papilloma (IP‐SCC) treated through an endoscopic approach and review the pertinent literature.

How to Prevent Diplopia in Endoscopic Transnasal Resection of Tumors Involving the Medial Orbital Wall

Laryngoscope, 124:2017–2020, 2014