Benjamin Verillaud

Surgical management of inverted papilloma: Approaching a new standard for surgery

Inverted papilloma surgery is currently performed primarily with an endoscopic approach, a technique that has a recurrence rate of 12%. However, a recent study reported a recurrence rate of 5% with a strategy based on subperiosteal dissection of the tumor, with limited indications for using an external approach. The aim of this work was to evaluate whether different teams using the same surgical concepts could reproduce the excellent results that were recently reported.

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

Laryngoscope, 124:2017–2020, 2014

How I do it. The pedicled temporoparietal fascia flap for skull base reconstruction after endonasal endoscopic approaches

BackgroundEndoscopic endonasal approaches (EEA) are an alternative for removing challenging nasopharyngeal or skull base lesions. In some cases, a nasoseptal flap (NSF) is not always available and such complex procedures may lead to carotid arteries exposition and/or dura mater (DM) wide opening. Meticulous carotid coverage and DM reconstruction are crucial for preventing early and delayed complications.MethodWe propose a step-by-step description of the pedicled temporoparietal fascia flap (TPFF) technique, with a focus on its pitfalls, advantages and limits.ConclusionThe TPFF is a reliable flap for skull base reconstruction when other pedicled flaps are not available.Key points1. Reliable flap even for irradiated patients2. CT angiography with 3D reconstruction as pre-operative imaging3. Doppler ultrasound probe to draw the artery’s trajectory on skin4. TPFF elevation concomitantly to the endoscopic procedure5. Hemicoronal incision sufficient to harvest the TPFF6. Superficial dissection in a plane just beneath the hair follicles7. Dissection plane deep to the fad pad to preserve the frontal branch of the facial nerve8. Surgical corridor wide enough to avoid any compression of the pedicle9. Double visualization to avoid any twist and Doppler control of the STA patency10. Close follow-up, toilet in clinics

Endoscopic endonasal resection of respiratory epithelial adenomatoid hamartomas of the sinonasal tract

Respiratory epithelial adenomatoid hamartomas (REAHs) are rare benign tumors and may manifest as either isolated lesions or in association with sinonasal polyposis. The aim of this study is to report our experience in the management of patients with REAH and to analyze the long‐term results of the endoscopic endonasal approach.

Value of double mucoperiosteal flaps to prevent restenosis in Draf IIb/III: First clinical report

The frontal sinus is the most challenging of all paranasal sinuses despite major advances in endoscopic approaches, instrumentations and image guidance systems. Draf IIb and III procedures include extensive bone drilling with resection of the mucosa. Leaving exposed drilled bone is a major factor that contributes to postoperative failure because it induces osteitis with subsequent neo-osteogenesis, scarring and ostium restenosis. Covering the posteriorly exposed bone with a single local mucoperiosteal flap was recently proposed to overcome this issue with promising results. Vascularised flaps are rapidly integrated to the bony surface allowing a complete epithelialisation that inhibits the osteitis process. A cadaver study described a double flap strategy in Draf III procedures covering both the anterior and posterior edges of the frontal cavity. The objective of this study was to demonstrate the clinical feasibility of double mucoperiosteal flaps in Draf IIb and III procedures by reporting the first clinical series and to evaluate the postoperative healing process.

Surgical landmarks of the nasopharyngeal internal carotid using the maxillary swing approach: A cadaveric study

Surgery of the paranasopharyngeal space is very hazardous due to the position of the internal carotid artery, which is surrounded by soft tissue with few anatomical landmarks.

99mTc-HMPAO-leukocyte scintigraphy for diagnosis and therapy monitoring of skull base osteomyelitis: Skull Base Osteomyelitis: therapeutic follow-up

Skull base osteomyelitis (SBO) is a rare but life‐threatening disease observed in elderly diabetic patients, with high risk of recurrence and difficult therapeutic management. The diagnosis is ascertained from a set of clinical, biological, and imaging findings. CT and MRI allow initial diagnosis, but are not accurate to affirm healing at the end of therapy. 99mTc‐HMPAO‐Leucocyte Scintigraphy (LS) is highly sensitive and specific for the detection of infection. The aim of this study was to evaluate LS i) for initial diagnosis, and ii) to confirm healing at the end of antibiotherapy in SBO.

Ethmoidal adenocarcinoma treated by exclusive endoscopic approach: Focus on learning curve and modification of management

The purpose of this study was to investigate the outcome and recurrences for ethmoidal adenocarcinomas treated by exclusive endoscopic surgery in curative intent and investigate the role of the learning curve.

Petrous and sphenoid arachnoid cysts: Diagnosis and management

Intraosseous arachnoid cysts are rare and difficult to diagnose. The purpose of this study was to describe the clinical and radiological semiology of petrous and sphenoid arachnoid cysts and to propose a specific management strategy.