Endonasal resection of a sinonasal hemangiopericytoma

AimHemangiopericytomas (HP) are rare perivascular neoplasms with variable biological behaviour. The prognosis, by histology alone, is difficult. The clinical course of disease and the localization of the tumour are of importance. Sinonasal HP is usually of low malignant potential. Currently, a less invasive, endonasal, approach is chosen for resection of such tumours. One case of sinonasal HP treated by endonasal surgery is presented.CaseA 61-year old man presented with nasal obstruction and stated that he had undergone endonasal surgery elsewhere twice before for “nasal polyps”, 19 and eight years previously. Anterior rhinoscopy revealed a polypoid lesion in the right nasal cavity. CT showed a mass of the right ethmoidal and sphenoidal sinus with no sign of bone destruction. We performed an endonasal total resection of the tumour. The histological diagnosis was of sinonasal HP. There was no local or remote metastasis. Histological reports of the earlier surgeries were compared and identified the same tumour.ConclusionsThe presented case shows a long-term benign course of recurrent sinonasal HP following endonasal resection. After more invasive approaches, such as lateral rhinotomy, local recurrence has been reported to appear within comparable periods of time. If the tumour is of limited extension, without infiltration of neighbouring structures, it can be removed via an endonasal approach

Znaczenie postępowania pooperacyjnego w operacjach czynnościowych nosa i zatok przynosowych

Introduction. In this work we wish to emphasize the importance of postoperative care of patients who underwent FESS in ENT Department Medical University in Poznań. We feel that too little attention is still being paid to this treatment as we mostly focus on surgery. Material and methods. Our observation are based on nine year experience in functional endoscopic sinus surgery. The analysis covers patients hospitalized in our Department from January 1998 to August 2007. The schedule of postoperative care has been presented. Results. 1463 FESS operation were carried out in our Department from January 1998 to August 2007. Similar postoperative procedures were used with each patient. Full recovery of mucous membrane depended on a few parameters such as: if the patient underwent FESS for the fi rst time, what kind of changes were observed: polips or chronic infection, as well as the method of surgery (“aggressive” versus “delicate”). Healing time ranged from 6 week to 3 month. Conclusions. The scheme of procedures employed comes useful in postoperative treatment after FESS