Endoscopic resection of inverted papilloma of the nose and paranasal sinuses

Abstract

The results of a retrospective study of 22 patients with inverted papillomas resected by the endoscopic approach are presented with a follow-up of 33 to 96 months. Twenty-one patients had unilateral disease and one patient had bilateral involvement. None of the patients had orbital or cranial extension. One patient had synchronous carcinoma in situ. Eight patients had undergone previous surgical procedures. Following endoscopic surgery, six patients had residual disease requiring further revisions. Three of these six patients eventually required excision via limited external approaches. No patient required lateral rhinotomy or mid-facial degloving procedures. No complication occurredin any of the patients. The advantages of endoscopic surgery include precise determination of tumour extent, preservation of normal mucosa and bony structures and avoidance of external scars. Close endoscopic follow-up is mandatory to ensure early recognition and treatment of recurrent disease. Although the endoscopic approach is gaining popularity for the treatment of inverted papilloma, indiscriminate application may result in a high recurrence rate. The endoscopic approach should be performed by experienced surgeons and restricted to carefully selected patients with nasal, ethmoidal and limited maxillary disease. More extensive disease should be managed by radical external approaches or by combining endoscopic with limited external approaches.

Current advances in the basic research and clinical management of sinonasal inverted papilloma (Review)

“…Furthermore, type I tumors result in nasal obstruction and early diagnosis while the lesion is still small, whereas type II lesions result in late diagnosis with broader extension (66). In terms of recurrence, Kamel et al agree with other authors that recurrence always occurs at the original site due to the incomplete removal of the primary lesion (6,7,67,68). Kamel et al recommend this new classification system to all cases of IP regardless of the extent of the tumor.…”

Management of Maxillary Sinus Inverted Papilloma via Transnasal Endoscopic Anterior and Medial Maxillectomy

“…Most recurrences from Krouse stage III IP are a result of incomplete resection of the tumor, especially at the site of its origin [20][21][22] . Transnasal endoscopic medial maxillectomy is accepted as indicated for IP arising from the medial, posterior, or inferior wall of the maxillary sinus [15] .…”

Bilateral inverted papilloma: A report of two cases and review of the current literature

“…Inverted papilloma is a rare benign sinonasal tumor, characterized by a potentially invasive nature and relatively high recurrence rates which tend to vary with the extent of primary lesion and the choice of surgery [8,9]. Both the cases presented here highlight this high recurrence rate.…”

“…However, over the last decade many reports have emerged using endoscopic techniques [9,[19][20][21][22] with rates of recurrence averaging out at 13.4%. A trend towards utilizing the improved endoscopic technology, including navigational systems, has slowly emerged [23].…”