Traditional open surgery for advanced benign nasal tumours in an era of endoscopy: review of 38 cases

During the past decade open nasal surgery has been overtaken by endoscopic resection in the management of benign sinonasal tumours in the advanced countries. However, due to limited availability of endoscopic surgical facilities and training in most parts of subSaharan Africa, open surgery still seems popular. This report determines the indications and outcome of open nasal surgery for benign tumours in a resource – poor tertiary centre in sub-Saharan Africa and compares with endoscopic resection. This is retrospective study of 38 open surgeries done by the authors for cases of benign sinonasal tumours. Seventeen (45%) caldwel-luc procedures, 12 (31%) external (lynch-howarth) fronto-ethmoidectomy and 9(24%) lateral rhinotomy were carried out. The indications were simple nasal polyps 17(45%), mucocoele 10(26%), inverted paplloma 8(21%), invasive fungal sinusitis 2(5%) and ossifying fibroma 1(2%). Postoperatively, recurrence was 1/17(6%) caldwel-Luc surgery and 1/9 (11%) lateral rhinotomy for inverted papilloma. Facial scar was seen in 21/38(55%) but the cosmetic effect of the scars was acceptable to our patients. Postoperative stay was between 5 to 17 days. We conclude that open nasal surgery met the therapeutic expectations of our patients. The recurrence rate compared with that of endoscopic resection reported in the literature and cosmetic effect of facial scar was acceptable to the patients, however, postoperative stay in the hospital is longer. It is our hope that this will serve as a baseline to compare the result of endoscopic nasal surgery in future when it becomes a widespread procedure in the developing countries.