Endoscopic Surgery of a Sinonasal Inverted Papilloma: Surgical Strategy, Follow-up, and Recurrence Rate

Jiang, Xiaodan; Dong, Qingyu; Li, Shenling; Huang, Tianqiao; Zhang, Niankai

doi:10.2500/ajra.2017.31.4387

Cited by 25 publications

(39 citation statements)

References 20 publications

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“…Furthermore, it has been shown that the specific resection technique correlates with recurrence rates. Attachment-oriented resection leads to decreased recurrence rates (<10%) [2,12,16,17,18,21,69,70]. This technique involves subperiosteal tumor resection at the site of tumor origin with a safety margin of 1–1.5 cm [12,15,16,18,38,69].…”

Section: Discussionmentioning

confidence: 99%

Surgery of Inverted Papilloma of the Maxillary Sinus via Translacrimal Approach—Long-Term Outcome and Literature Review

Hildenbrand

Weber

Mertens

et al. 2019

JCM

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There are several differential diagnoses of unilateral sinus disease. One of these is inverted papilloma (IP) of the maxillary sinus, which is a common benign tumor with a substantial rate of malignant transformation. In general, endoscopic endonasal techniques for addressing the tumor are favored nowadays instead of classical external approaches. The aim of this retrospective study was to investigate the long-term outcome of inverted papilloma treated endoscopically via the prelacrimal approach. We reviewed 17 patients with primary or recurrent IP of the maxillary sinus that were treated via the prelacrimal endoscopic endonasal technique. After a median follow-up period of 45.9 months (3.8 years), none of the 17 included patients showed signs of recurrent disease and no serious complications were reported. Hypoesthesia of the incisors was reported by four patients and was resolved with time in one. All of the maxillary sinuses could be fully visualized with the flexible endoscope. IP is an important differential diagnosis in the clinical finding of unilateral nasal polypoid lesions. The prelacrimal approach is an effective and safe method in the treatment of IP with limited patient morbidity.

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Section: Discussionmentioning

confidence: 99%

Surgery of Inverted Papilloma of the Maxillary Sinus via Translacrimal Approach—Long-Term Outcome and Literature Review

Hildenbrand

Weber

Mertens

et al. 2019

JCM

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“…It has been suggested that the risk of recurrence of SNIP is likely to be a consequence of incomplete surgical resection, rather than due to specific characteristics of the tumor itself, particularly because most SNIP recur at the same site where the tumor originated . Thus, the concept of SNIP resection has changed from aggressive surgery to pedicle‐oriented endoscopic surgery . However, some studies have recommended routine endoscopic surgery combined with an advanced endonasal approach or external approach, because some sites of the tumor origin were located in anatomic areas, which were hard to access by endoscopy alone …”

Section: Discussionmentioning

confidence: 99%

“…5,10 Thus, the concept of SNIP resection has changed from aggressive surgery to pedicle-oriented endoscopic surgery. 2,5,6,22 However, some studies have recommended routine endoscopic surgery combined with an advanced endonasal approach or external approach, because some sites of the tumor origin were located in anatomic areas, which were hard to access by endoscopy alone. 23,24 In this study, we performed a retrospective cluster analysis of data from a preliminarily investigation involving a cohort of 200 patients with SNIPs from 6 centers and developed a staging system for assessment of SNIP recurrence risk and appropriate surgical approach recommended, based on the originating site of the tumor.…”

Section: Discussionmentioning

confidence: 99%

Origin site‐based staging system of sinonasal inverted papilloma for application to endoscopic sinus surgery

et al. 2018

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Background We aimed to assess the recurrence risk of sinonasal inverted papillomas (SNIPs), based on a staging system developed according to the originating site of SNIP. Methods A total of 200 patients with SNIP were enrolled, and a staging system was developed based on the originating sites and corresponding recurrence rates of tumor in the patients. In the verification phase, 675 patients with SNIPs were enrolled as above, and the originating sites of the SNIPs were confirmed by an endoscopic sinus surgery. Cluster analysis was performed to determine the stage for each SNIP. Results Overall, 608 patients completed the study. SNIP recurrence rates for stages 1‐4 were 0 (n = 43), 4.0% (n = 420), 13.4% (n = 134), 36.4% (n = 11), respectively (total = 6.4%). Conclusions The origin site‐based classification of SNIP may aid surgeons in selecting appropriate endoscopic surgical approaches to minimize the risk of recurrence.

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“…While we aimed to acquire long-term data on IP recurrence within our cohort, with a mean follow-up of 31.1 months, this still may not have adequately captured all cases of recurrence. It has been reported that up to 20% of recurrences may occur 5 years after resection for all IPs [ 28 ]. However, specific for maxillary IPs, recurrences have been noted to occur within a mean time of 20 months [ 7 ].…”

Section: Discusssionmentioning

confidence: 99%

Endoscopic management of maxillary sinus inverted papilloma attachment sites to minimize disease recurrence

Siu

Yip

et al. 2018

Journal of Otolaryngology - Head & Neck Surgery

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BackgroundInverted papillomas (IPs) are benign neoplasms, most commonly arising from the mucosal lining of the maxillary sinus. IPs can have single or multifocal sites of attachment. Although pedicle location is an important factor to consider in surgical planning, it is less clear whether the location or number of IP attachment sites hold any prognostic value. Herein, we aimed to determine the prognostic significance of the number and location of attachment sites of IPs originating from the maxillary sinus when managed by a pure endoscopic approach.MethodsThis was a single-center, single-surgeon retrospective chart review. Patients with maxillary sinus IPs who were managed by endoscopic approaches only, from January 1, 2010 to June 30, 2016, were identified. Demographic data, operative technique, number and location of IP attachment sites, follow-up duration, recurrence, and presence of malignant transformation were captured.ResultsTwenty-eight maxillary IP patients (61% males) were included, with a mean age of 54.9 (standard deviation (SD): 16.5) years. Approximately 36% of patients were referred from other institutions for management of recurrent IPs after failing previous surgical treatment. All patients were managed with an endoscopic approach, and all required an endoscopic medial maxillectomy to facilitate access to the maxillary sinus. At a mean follow-up of 31.1 (SD: 22.6) months, there were no recurrences identified. IPs with single (46%) and multifocal (54%) attachments were predominately to the medial and lateral walls. Maxillary IPs with multifocal attachments most frequently involved 2-3 walls of the sinus. Osteitis (36%) was commonly seen.ConclusionIPs originating from the maxillary sinus frequently had multifocal attachments, but this did not impact disease recurrence. Despite the surgical challenges of accessing all of the maxillary sinus walls, IPs originating from the maxillary sinus can be effectively managed via a pure endoscopic approach.

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Endoscopic Surgery of a Sinonasal Inverted Papilloma: Surgical Strategy, Follow-up, and Recurrence Rate

Abstract: Endoscopic surgery may be preferred for treating SNIP. The elevated recurrence rate after revision emphasized the significance of the first surgery. We encourage a follow-up period of at least 5 years.

Cited by 25 publications

References 20 publications

Surgery of Inverted Papilloma of the Maxillary Sinus via Translacrimal Approach—Long-Term Outcome and Literature Review

Surgery of Inverted Papilloma of the Maxillary Sinus via Translacrimal Approach—Long-Term Outcome and Literature Review

Origin site‐based staging system of sinonasal inverted papilloma for application to endoscopic sinus surgery

Endoscopic management of maxillary sinus inverted papilloma attachment sites to minimize disease recurrence

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