Inverted Papilloma Ooriginating from the Opticocarotid Recess

Abstract

Objective: 1) Understand the relationship of the opticocarotid recess with the surrounding structures. 2) Explain the pathophysiology and natural history of an inverting papilloma (IP) in the sphenoid sinus. 3) Examine the significance of a neoplasm originating from the anterior clinoid.

Method: This case report was conducted in a tertiary hospital setting in June 2011. The subject, a 49-year-old woman, presented with an inverting papilloma originating from the opticocarotid recess causing optic nerve dehiscence. The intervention was endoscopic excision. Outcome was measured by clinical examination, and follow-up patient analysis is ongoing.

Results: The patient was found to have an inverting papilloma (IP) of the sphenoid sinus. During endoscopic sinus surgery, the inverted papilloma was visualized originating from the sphenoid sinus and causing bony erosion in the area of the opticocarotid recess. An area of optic nerve dehiscence was identified, and the sheath of the optic nerve was clearly visualized once the tumor was peeled off the optic canal. Pathology confirmed the diagnosis of inverting papilloma and was negative for carcinoma. Follow-up clinical examination of the patient revealed that endoscopic excision effectively removed the neoplasm without local complications or recurrence.

Conclusion: Inverting papillomas originating from the region of the opticocarotid recess are an atypical entity and have the potential to cause rare, but serious, complications. The authors are unaware of any reported cases of an IP originating from this area. Early, effective management is crucial given the vital structures at risk.