Large nasal hemangioma with en bloc resection by an endonasal endoscopic approach combined with transseptal access with crossing multiple incisions and Endoscopic Denker’s Approach: A case report

DOI Web Site 12 References
  • Matsumoto Junya
    Department of Otolaryngology, Kochi Health Sciences Center
  • Makihara Seiichiro
    Department of Otolaryngology-Head ＆ Neck Surgery, Kagawa Rosai Hospital
  • Omura Kazuhiro
    Department of Otorhinolaryngology, The Jikei University School of Medicine
  • Naito Tomoyuki
    Department of Otoralyngology Head and Neck Surgery, Kagawa Prefectual Central Hospital
  • Doi Akira
    Department of Otolaryngology, Kochi Health Sciences Center
  • Kariya Shin
    Department of Otolaryngology-Head & Neck Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
  • Ando Mizuki
    Department of Otolaryngology-Head & Neck Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences

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Other Title
  • TACMI法とEndoscopic Denke’s Approachの併用により摘出しえた鼻腔血管腫の1例

Abstract

Nasal hemangioma, particularly giant hemangioma, has a rich blood supply, and surgical treatment requires particular care due to the high risk of massive bleeding and obstructed field of view. <br>The case was a 78-year-old male who presented with recurrent left nasal bleeding, with hemangioma filling the left nasal cavity. As preoperative embolization was not possible, the sphenopalatine artery, which is a feeder, needed to be clamped at the beginning of the surgery. <br>For en bloc resection, the endonasal endoscopic approach was selected combined with transseptal access with crossing multiple incisions （TACMI） and endoscopic Denker’s approach for coagulation of the sphenopalatine artery. <br>This case study shows that the sphenopalatine artery of a large nasal tumor, which is difficult to approach by the standard middle meatal antrostomy or endoscopic medial maxillectomy, can be approached endonasally by TACMI and endoscopic Denker’s approach.

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