ENDOSCOPIC ENDONASAL TREATMENT OF PRIMARY INVERTED PAPILLOMA OF THE SPHENOID SINUS: A CLINICAL CASE.

AIMS: To describe a case of primary inverted papilloma of the sphenoid sinus and to illustrate the technical aspects of the endoscopic endonasal procedure with posterior septectomy, combining clinical and radiological findings. STUDY DESIGN: Clinical case report. PLACE AND DURATION OF STUDY: City Clinical Hospital No. 5, Dostyk Street 220, Almaty, Kazakhstan. From initial presentation to 6-months post-operative follow-up. SAMPLE: A 30-year-old male patient with 7 years of progressive sinonasal symptoms. METHODOLOGY: The patient had nasal endoscopy, CT and MR imaging. The tumor was removed via endoscopic endonasal approach with posterior septectomy. The diagnosis was confirmed by histopathology. RESULTS: Endoscopic resection was performed without complications. Total operative duration was 95 minutes. Patient's intraoperative blood loss was 80 mL. There were no intraoperative or postoperative complications, no need for nasal packing beyond routine care, and no postoperative bleeding or infection. Headache decreased from VAS 7 to 0 within one week. Nasal obstruction decreased from VAS 8 to 0 by week two. Olfactory function recovered by week six. Six-month CT showed no evidence of recurrence. CONCLUSION: Endoscopic surgery with a posterior septectomy demonstrates feasibility in the treatment of primary sphenoid sinus inverted papilloma in this case. Complete macroscopic resection was achieved without perioperative complications, need for transfusion, cerebrospinal fluid leak, visual disturbance, septal perforation, or prolonged hospitalization, and with no evidence of recurrence at six months, indicating short-term disease control.