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A Combined Transoral and Transnasal Endoscopic Approach to Resection of Maxillary Ameloblastoma with Extension to the Anterior Skull Base
Author(s) -
Scott Andrew R.,
Lin Derrick T.
Publication year - 2009
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1002/lary.20357
Subject(s) - presentation (obstetrics) , section (typography) , skull , resection , citation , ameloblastoma , base (topology) , extension (predicate logic) , anatomy , art , medicine , library science , art history , computer science , general surgery , surgery , maxilla , programming language , mathematics , mathematical analysis , operating system
Ameloblastoma is a rare, odontogenic tumor, which arises from dental epithelium that is of enamel tissue type but does not undergo transformation to the point of enamel formation. The literature sites a predominance of mandibular involvement over maxillary origin by a factor of approximately 4:1. While these tumors are considered benign owing to the fact that they do not metastasize, they are locally destructive. We describe a case of an 86 year old woman who presented with progressive left-sided nasal obstruction and rhinorrhea. Physical examination and imaging revealed tumor filling the left maxillary sinus and nasal cavity with extension to the anterior skull base. A transnasal biopsy was diagnostic of ameloblastoma. The maxillary component of the mass was successfully resected via a transoral left palatectomy. The remainder of the tumor, which filled the left nasal cavity, ethmoid air cells, and frontal sinus was removed through a transnasal endoscopic approach. In this report we review the epidemiology, presenting symptoms, and clinical characteristics of maxillary ameloblastoma and we describe a novel approach to resection of these locally aggressive tumors.