Endonasal Endoscopic Removal of a Langerhans Cell Histiocytosis from Far Lateral Frontal Sinus


Akyildiz H. S., BAŞAK H., BETON S., MEÇO C.

INDIAN JOURNAL OF OTOLARYNGOLOGY AND HEAD & NECK SURGERY, cilt.74, ss.4649-4652, 2022 (ESCI) identifier identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 74
  • Basım Tarihi: 2022
  • Doi Numarası: 10.1007/s12070-021-02968-0
  • Dergi Adı: INDIAN JOURNAL OF OTOLARYNGOLOGY AND HEAD & NECK SURGERY
  • Derginin Tarandığı İndeksler: Emerging Sources Citation Index (ESCI), Scopus
  • Sayfa Sayıları: ss.4649-4652
  • Anahtar Kelimeler: Frontal sinus, Langerhans cell histiocytosis, Sinonasal tumor, Endonasal endoscopic surgery, Minimally invasive, SPHENOID SINUS
  • Ankara Üniversitesi Adresli: Evet

Özet

Introduction: Langerhans cell histiocytosis (LCH) is a rare disease in adults, and it is even uncommon in pediatric populations, affecting only 1-2 people per million. A LCH located in the frontal sinus is exceptionally unusual. We present a case of LCH located in the far lateral of the frontal sinus and discuss management as well as surgical techniques to control this far lateral frontal sinus lesion. Case Presentation: A 39 year old female, presented with a history of progressive headaches and purulent nasal discharge for three months. Computed tomography (CT) of the sinuses showed an approximately 15 x 10 mm soft tissue with osteolytic bony changes located in lateral wall of the frontal sinus on the left side. Total tumor removal was achieved by minimally invasive endonasal endoscopic surgery with a periorbital suspension technique. Histopathologic analysis revealed LCH and the patient was referred to a hematologist for further treatment. Conclusion: LCH is a rare hematological pathology. It should be diagnosed timely and treated with a multidisciplinary approach. To get a definitive diagnosis a biopsy is mandatory. Having LCH in the far lateral frontal sinus can be challenging for a biopsy even for experienced surgeons. Using curved instruments while performing an endonasal periorbital suspension technique makes it possible to access the lateral wall of the frontal sinus safely and provides an effective surgical route similar to traditional open approaches without causing any external scars.