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| Name | ENDOSCOPIC EXCISION OF FIBROUS DYSPLASIA//MODIFIED DENKER APPROACH//COMPLETLY ENDOSCOPIC APPROACH |
| Video Uploader | Video From ENT surgery lecture by Dr Sunil Kumar Sharma |
| Upload Date | This Video Uploaded At 23-04-2025 11:56:46 |
| Video Discription | A 30-year-old female presented with a six-month history of left-sided malar swelling and progressive nasal obstruction. There was no history of epistaxis or visual symptoms, but the external facial asymmetry was quite evident. We obtained a CT scan of the paranasal sinuses, which revealed a left-sided lesion showing a classic ground-glass appearance. The lesion caused significant expansion of the maxillary bone with well-defined margins. Importantly, there was homogeneous density throughout—consistent with a monostotic fibrous dysplasia. Given the extent of involvement and the cosmetic deformity, we planned for surgical excision using a complete endoscopic Denker’s approach. Intraoperatively, after establishing access through the inferior meatus and anterior maxillary wall, we carefully dissected the nasolacrimal duct, preserving it entirely. From there, we defined the infraorbital neurovascular bundle, which was well-visualized and protected throughout the procedure. The lesion was then completely dissected out in a piecemeal fashion. Although fibrous dysplasia isn’t typically encapsulated, the clear bony margin and distinct consistency allowed for precise removal. After debulking, we used a high-speed diamond burr to drill down the bony walls, ensuring we addressed any residual dysplastic bone and minimized the risk of regrowth. The key here was that the entire surgery was conducted endoscopically—no external incisions, minimal morbidity, and excellent exposure of the maxillary sinus, nasolacrimal duct, and infraorbital structures. Post-operatively, the patient had excellent recovery, with resolution of the nasal obstruction and a noticeable reduction in the malar swelling within the first month. Long-term follow-up will include serial imaging to monitor for recurrence, although recurrence rates are low after complete excision and thorough bony drilling. This case is a great example of how endoscopic techniques—when properly applied—can manage even extensive fibro-osseous lesions in the sinonasal region with precision and minimal invasiveness. #science #ear #ent #anatomy #biology #nose #nosebleed #otolaryngology #throathealth #tonsils |
| Category | Education |
| Tags | FIBROUS DYSPLASIA | Endoscopic fibrous dysplasia excision | DENKER approach |
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