A Patient Benefits from Transnasal Endoscopic Surgery for a Sphenoid Inverted Papilloma
The sphenoid sinus is a rare location for an inverted nasal papilloma, a usually benign but occasionally invasive and locally destructive tumor. Primary treatment is almost always surgery, made complex by difficult access and proximity to the internal carotid artery and nerves. When Chris Manthei’s ENT discovered that a large sphenoid tumor was causing his nasal congestion, he referred him to rhinologist Martin Citardi, MD, professor and chair of the Department of Otorhinolaryngology at McGovern Medical School at UTHealth Houston.
Dr. Citardi saw Manthei in late summer of 2021. “Everyone was polite, professional, and reassuring,” Manthei says. “He explained the surgery and the equipment he would use to minimize the invasiveness of the procedure. He said it was serious but not to worry because they had me covered. All the residents were there at my next appointment, and when I was surprised to see so many doctors, he explained that I had a rare condition and was being treated at a teaching hospital. I joked that I would prefer to be a boring patient.”
Dr. Citardi took Manthei to the OR a few weeks after his initial visit. “At the last appointment before my surgery, I brought my wife, who is a nurse, so she could ask the hardcore questions,” he says. “I’ve had trouble in the past with anesthesia and met with the anesthesiologist before the surgery. He was reassuring and said he would take all this into consideration. I was perfectly calm and comfortable during the entire experience, and when I woke up after the surgery, it was like coming out of a deep sleep. I would describe the entire experience as uneventful.”
Manthei says he felt so good after the outpatient surgery that he suggested to his wife that they stop by his office on the way home. “She said no and drove me home, which was a good thing because when the pain medication wore off, I was groggy. But the next day I felt good and was well on the way to recovery.”
He followed up with Dr. Citardi two weeks later. “Inverted papilloma can recur so I saw him periodically to make sure it didn’t come back, and then my follow-up visits were scheduled further and further apart,” Manthei says.
“It was a challenging surgery, but I believe we removed all of the tumor,” Dr. Citardi says. “On examination I can see back into the sphenoid cavity, and it looks perfect.”