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

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Abstract

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 × 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.

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Funding

This study did not receive any specific grant from funding agencies in the public, commercial, or not for profit sectors.

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Authors and Affiliations

  1. Department of Otorhinolaryngology, Ankara University School of Medicine, Ankara, Turkey

    Hatice Secil Akyildiz, Hazan Basak, Suha Beton & Cem Meco

  2. Department of Otorhinolaryngology, Salzburg Paracelsus Medical University, Salzburg, Austria

    Cem Meco

Authors
  1. Hatice Secil Akyildiz
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  2. Hazan Basak
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  3. Suha Beton
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  4. Cem Meco
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Contributions

Conception: HSA, HB, SB; Design: HB, HSA, SB, CM; Data Collection and/or Processing: HSA, HB, SB; Analysis and/or İnterpretation: HB, HSA, CM; Literature Review: HSA, HB, SB,CM; Writing Manuscript: HSA, HB; Critical Review: HB, HSA, SB, CM.

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Correspondence to Hatice Secil Akyildiz.

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Our study includes data from one human participiant, and the patient’s consent was obtained. The datasets used and/or analysed during the current study are available from the corresponding author on reasonable request.

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Akyildiz, H.S., Basak, H., Beton, S. et al. Endonasal Endoscopic Removal of a Langerhans Cell Histiocytosis from Far Lateral Frontal Sinus. Indian J Otolaryngol Head Neck Surg 74 (Suppl 3), 4649–4652 (2022). https://doi.org/10.1007/s12070-021-02968-0

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  • DOI: https://doi.org/10.1007/s12070-021-02968-0

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