Endoscopic management of a nasal septal pleomorphic adenoma

Pleomorphic adenoma is one of the most common benign tumors of the major salivary glands. Eighty percent of these tumors arise from the parotid gland. These adenomas rarely develop from the minor salivary glands found in the nasal mucosa. To date, there have been 58 reported cases of nasal septal pleomorphic adenomas. Surgical excision was usually achieved by lateral rhinotomy, midfacial degloving, or transpalatal surgery. The midfacial degloving technique is described as the gold standard; however, endoscopic excision has been associated with lower morbidity, reduced intraoperative bleeding, reduced hospital length of stay, improved tumor margin visualization, and lower recurrence rates. In this case report, we describe our endoscopic technique for the removal of a 6.2 cm pleomorphic adenoma of the nasal septum in a 35-year-old female. We also review the current literature to compare outcomes and complications of midfacial degloving versus endoscopic surgical techniques in the resection of nasal septal tumors. The endoscopic approach used in this case adds to the previous literature on alternatives to midfacial degloving for the removal of nasal septal tumors.