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Peng R, Thamboo A, Choby G, Ma Y, Zhou B, Hwang PH. Outcomes of sinonasal inverted papilloma resection by surgical approach: an updated systematic review and meta‐analysis. Int Forum Allergy Rhinol 2019; 9:573-581. [DOI: 10.1002/alr.22305] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2018] [Revised: 12/20/2018] [Accepted: 01/08/2019] [Indexed: 12/18/2022]
Affiliation(s)
- Rui Peng
- Department of Otolaryngology–Head and Neck SurgeryStanford University School of Medicine Stanford CA
- Department of Otolaryngology–Head and Neck Surgery, Beijing Tongren HospitalCapital Medical University Beijing China
| | - Andrew Thamboo
- Department of Otolaryngology–Head and Neck SurgeryStanford University School of Medicine Stanford CA
- Department of Surgery, Division of OtolaryngologyUniversity of British Columbia Vancouver BC Canada
| | - Garret Choby
- Department of Otolaryngology–Head and Neck SurgeryStanford University School of Medicine Stanford CA
- Department of Otorhinolaryngology–Head and Neck SurgeryMayo Clinic Rochester MN
| | - Yifei Ma
- Department of Otolaryngology–Head and Neck SurgeryStanford University School of Medicine Stanford CA
| | - Bing Zhou
- Department of Otolaryngology–Head and Neck Surgery, Beijing Tongren HospitalCapital Medical University Beijing China
| | - Peter H. Hwang
- Department of Otolaryngology–Head and Neck SurgeryStanford University School of Medicine Stanford CA
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Sinonasal inverted papilloma associated with small cell neuroendocrine carcinoma: A case report and literature review of rare malignancies associated with inverted papilloma. Auris Nasus Larynx 2018; 46:641-650. [PMID: 30545727 DOI: 10.1016/j.anl.2018.10.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2018] [Revised: 10/05/2018] [Accepted: 10/17/2018] [Indexed: 12/29/2022]
Abstract
We report a rare case of sinonasal inverted papilloma (IP) associated with small cell neuroendocrine carcinoma (SNEC). To our knowledge, this is the first report to describe SNEC found during the treatment of sinonasal IP. Surgery and five cycles of cisplatin plus etoposide with concurrent intensity modulated radiation therapy were performed. Neither local recurrence nor distant metastasis was noted during 6 years of post-diagnostic follow-up. The prognosis of SNEC is very poor. Treatment planning for sinonasal IP should consider a possible association with this rare but aggressive malignancy, whose treatment is completely different from that of squamous cell carcinoma, a malignancy which is commonly associated with IP. We also performed a PubMed review of the literature to identify the incidence and pathological diagnosis of associated malignancy. Among a total of 5286 cases of sinonasal IP (61 studies), the incidence of associated malignancy was 8.02% in squamous cell carcinoma, 0.19% in transitional cell carcinoma, 0.04% in mucoepidermoid carcinoma, 0.02% in verrucous cell carcinoma and 0.02% in adenocarcinoma. The incidence of associated malignancy was significantly higher in East and Southeast Asia (11.0%) and North America (10.4%) than in Europe (3.9%) (p=0.04 and p=0.03, respectively; T-test).
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Yasukawa S, Kano S, Hatakeyama H, Nakamaru Y, Takagi D, Mizumachi T, Suzuki M, Suzuki T, Nakazono A, Tanaka S, Nishihara H, Homma A. Genetic mutation analysis of the malignant transformation of sinonasal inverted papilloma by targeted amplicon sequencing. Int J Clin Oncol 2018; 23:835-843. [PMID: 29779136 DOI: 10.1007/s10147-018-1296-1] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Accepted: 05/14/2018] [Indexed: 12/23/2022]
Abstract
BACKGROUND The mechanism underlying the malignant transformation of inverted papilloma (IP) has not yet been elucidated. METHODS To clarify the genes responsible for the malignant transformation, we analyzed 10 cases of IP, 8 of IP with dysplasia, and 11 of squamous cell carcinoma (SCC) by targeted amplicon sequencing. RESULTS The number of mutant genes increased in the order of IP < dysplasia < SCC. Significant differences were observed in the mutation rates of three genes (KRAS, APC and STK11) in particular. TP53 was altered frequently in each group and might be involved in malignant transformation based on to the site of the mutation. A comparison of the genetic variants by region of IP tissue among patients with IP alone, and those with dysplasia or SCC revealed significant differences in the mutation rate of the KRAS gene. CONCLUSION Identification of genetic mutations in KRAS is effective for predicting the malignant transformation of IP.
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Affiliation(s)
- Shinichiro Yasukawa
- Department of Otolaryngology, Head and Neck Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Kita 15, Nishi 7, Kita-ku, Sapporo, 060-8638, Japan
| | - Satoshi Kano
- Department of Otolaryngology, Head and Neck Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Kita 15, Nishi 7, Kita-ku, Sapporo, 060-8638, Japan.
| | - Hiromitsu Hatakeyama
- Department of Otolaryngology, Yokohama City University Medical Center, Yokohama, Japan
| | - Yuji Nakamaru
- Department of Otolaryngology, Head and Neck Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Kita 15, Nishi 7, Kita-ku, Sapporo, 060-8638, Japan
| | - Dai Takagi
- Department of Otolaryngology, Head and Neck Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Kita 15, Nishi 7, Kita-ku, Sapporo, 060-8638, Japan
| | - Takatsugu Mizumachi
- Department of Otolaryngology, Head and Neck Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Kita 15, Nishi 7, Kita-ku, Sapporo, 060-8638, Japan
| | - Masanobu Suzuki
- Department of Otolaryngology, Head and Neck Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Kita 15, Nishi 7, Kita-ku, Sapporo, 060-8638, Japan
| | - Takayoshi Suzuki
- Department of Otolaryngology, Head and Neck Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Kita 15, Nishi 7, Kita-ku, Sapporo, 060-8638, Japan
| | - Akira Nakazono
- Department of Otolaryngology, Head and Neck Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Kita 15, Nishi 7, Kita-ku, Sapporo, 060-8638, Japan
| | - Shinya Tanaka
- Department of Cancer Pathology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | | | - Akihiro Homma
- Department of Otolaryngology, Head and Neck Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Kita 15, Nishi 7, Kita-ku, Sapporo, 060-8638, Japan
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Kashlan K, Craig J. Dimensions of the medial wall of the prelacrimal recess. Int Forum Allergy Rhinol 2018; 8:751-755. [PMID: 29446869 DOI: 10.1002/alr.22090] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2017] [Revised: 12/13/2017] [Accepted: 01/04/2018] [Indexed: 11/07/2022]
Abstract
BACKGROUND Addressing anterior maxillary sinus pathology endoscopically that is inaccessible with an endoscopic modified medial maxillectomy requires either a prelacrimal approach (PLA) or an endoscopic Denker's approach (EDA). The PLA involves removing the medial wall of the prelacrimal recess (PLR), which is the bone between the pyriform aperture (PA) and nasolacrimal duct (NLD), from nasal floor to orbital floor. The PLA preserves the inferior turbinate and NLD, whereas both are sacrificed during an EDA. The purpose of this computed tomography (CT)-based study was to determine the anteroposterior and superoinferior dimensions of the medial wall of the PLR. METHODS One hundred thirty-one triplanar sinus CT scans of patients with various rhinologic diseases, but with intact bony PLR walls, were reviewed to assess dimensions of the medial wall of the PLR. The anteroposterior distances from the PA to the inferior-most, middle, and superior-most aspects of the NLD were measured. The height from the nasal floor to orbital floor was also measured. Combining left and right sides, there were 262 measurements. RESULTS The anteroposterior distances between the PA and the NLD were as follows: inferior: mean, 8.4 mm (standard error [SE], 0.2; range, 1.9-14.2); middle: mean, 7.6 mm (SE, 0.2; range, 0-13.6); and superior: mean, 5.5 mm (SE, 2.5; range, 0-11.9). The mean height of the medial wall of the PLR was 26.5 mm (SE, 0.2; range, 18.5-39.9). CONCLUSION The anteroposterior and superoinferior dimensions of the medial wall of the PLR are variable, with the anteroposterior dimension being widest inferiorly. Its dimensions should be evaluated preoperatively when considering endoscopic approaches to or through the anterior maxillary sinus.
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Affiliation(s)
- Khaled Kashlan
- Department of Otolaryngology, Henry Ford Hospital, Detroit, MI
| | - John Craig
- Department of Otolaryngology, Henry Ford Hospital, Detroit, MI
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Bradoo R, Joshi A, Shah K, Patel T, Lohiya T. The Four-Port Bradoo Technique: An Alternative to the Modified Endoscopic Denker's Approach for Giant JNA. Indian J Otolaryngol Head Neck Surg 2017; 69:277-281. [PMID: 28929055 DOI: 10.1007/s12070-017-1150-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2017] [Accepted: 06/16/2017] [Indexed: 11/28/2022] Open
Abstract
The aim of this study is to emphasise the importance of preserving the anterior facial skeleton in angiofibroma surgery and to introduce a new approach by which tumors with far lateral extensions can be operated upon successfully without disruption of the anterior facial skeleton. This is a prospective study conducted at a tertiary referral academic centre. Two patients with extensive juvenile nasopharyngeal angiofibroma with far lateral extensions were recruited and they underwent surgery between July and August 2016. Both patients were not embolised prior to surgery. Complete tumor removal was achieved in both cases without any evidence of recurrence of disease. The facial contour was well maintained. They are under regular follow-up at our centre, having completed their third 3 monthly follow-up. The main outcome measures are preservation of the anterior facial skeleton and complete tumor removal. The Four-Port Bradoo Technique allows for maximum access to the angiofibroma whilst maintaining the anterior facial skeleton, thus ensuring complete removal with minimal morbidity to the patient.
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Affiliation(s)
- Renuka Bradoo
- Department of ENT and Head-Neck Surgery, Lokmanya Tilak Municipal Medical College and General Hospital (Sion Hospital), Room No 441, 4th Floor, College Building, Sion, Mumbai, 400022 India
| | - Anagha Joshi
- Department of ENT and Head-Neck Surgery, Lokmanya Tilak Municipal Medical College and General Hospital (Sion Hospital), Room No 441, 4th Floor, College Building, Sion, Mumbai, 400022 India
| | - Kshtij Shah
- Department of ENT and Head-Neck Surgery, Lokmanya Tilak Municipal Medical College and General Hospital (Sion Hospital), Room No 441, 4th Floor, College Building, Sion, Mumbai, 400022 India
| | - Tejal Patel
- Department of ENT and Head-Neck Surgery, Lokmanya Tilak Municipal Medical College and General Hospital (Sion Hospital), Room No 441, 4th Floor, College Building, Sion, Mumbai, 400022 India
| | - Tanvi Lohiya
- Department of ENT and Head-Neck Surgery, Lokmanya Tilak Municipal Medical College and General Hospital (Sion Hospital), Room No 441, 4th Floor, College Building, Sion, Mumbai, 400022 India
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Wassef SN, Batra PS, Barnett S. Skull base inverted papilloma: a comprehensive review. ISRN SURGERY 2012; 2012:175903. [PMID: 23346418 PMCID: PMC3549337 DOI: 10.5402/2012/175903] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/02/2012] [Accepted: 10/17/2012] [Indexed: 11/23/2022]
Abstract
Skull base inverted papilloma (IP) is an unusual entity for many neurosurgeons. IP is renowned for its high rate of recurrence, its ability to cause local destruction, and its association with malignancy. This paper is a comprehensive review of the reports, studies, and reviews published in the current biomedical literature from 1947 to September 2010 and synthesize this information to focus on its potential invasion to the base of the skull and possible intradural extension. The objective is to familiarize the clinician with the different aspects of this unusual disease. The role of modern diagnostic tools in medical imaging in order to assess clearly the limits of the tumors and to enhance the efficiency and the safety in the choice of a surgical approach is pointed out. The treatment guidelines for IP have undergone a complex evolution that continues today. Radical excision of the tumour is technically difficult and often incomplete. Successful management of IP requires resection of the affected mucosa which could be achieved with open surgery, endoscopic, or combined approach. Radio and chemotherapy were used for certain indications. More optimally research would be a multicenter randomized trials with large size cohorts.
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Affiliation(s)
- Shafik N Wassef
- Department of Neurosurgery, University of Iowa Hospitals and Clinics, Iowa City, IA 52242, USA ; McConnell Brain Imaging Center, Montreal Neurological Institute and Hospital, McGill University, Montreal, QC, Canada H3A 2B4 ; Department of Neurology and Neurosurgery, McGill University, Montreal, QC, Canada H3A 2B4
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Kotulska-Kliś M, Jaśkiewicz-Burnejko E. [Inverted papilloma of the nose and paranasal sinuses in endoscopic surgery of the Otolaryngology Clinical Division in 4-th Clinical Military Hospital in Wrocław between years 2006-2008]. Otolaryngol Pol 2010; 63:50-3. [PMID: 20564901 DOI: 10.1016/s0030-6657(09)70189-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The aim of presented work is analysis of the inverted papilloma cases treated by endoscopic surgery between years 2006 and 2008. Within this period there were 180 surgeries, out of which 11 patients were diagnosed with papilloma inversum in the histopatological test of irradiated tissue. Symptoms reported by the patients, tumor loci, scope of the surgery and its efficiency are described and analyzed. The arguments supporting endoscopic surgery as a treatment modality for inverted papilloma are presented.
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Stange T, Schultz-Coulon HJ. [Surgical management of inverted papillomas of the nose and paranasal sinuses]. HNO 2008; 56:614-22. [PMID: 17891364 DOI: 10.1007/s00106-007-1607-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
INTRODUCTION Inverted papillomas require radical resection because of their high recurrence rate and expansive growth and the risk of malignant degeneration. Since the late 1980s surgical resection has been performed predominantly as an endoscopy-/microscopy-aided procedure through an endonasal approach. The extranasal approach is only used in the case of papillomas in unusual locations or ones that have expanded to an exceptional degree. The goal of the present study was a comparative evaluation of the results of this relatively new treatment strategy and of external sinus surgery in our own patients, with particular reference to the recurrence rate. PATIENTS AND METHODS Since 1989 a total of 80 patients have undergone surgery for inverted papilloma and have been followed up at regular intervals by means of endoscopic examinations. In any patients with a recurrence the revision operation was carried out through an extranasal approach when the papilloma was in the anterior or laterocaudal maxillary sinus or in the frontal sinus; in all other cases an endonasal approach was used for the revision surgery. The mean period of follow-up was 43 months (range 15 months to 16years). RESULTS In most patients (n=64, 80%) the endonasal surgical approach was used for the primary surgical treatment, while in 16 patients (20%) an extranasal approach was used initially. In 2 patients (2.6%) a squamous cell carcinoma was discovered adjacent to the papilloma. These two therapeutic special cases were not considered evaluable in the analysis of recurrences. Recurrences were seen in 14 patients (17.9%, n=78), in 11 patients after endonasal surgery (17.5%, n=11) and in 3 (20%, n=15) after extranasal resection. The majority of recurrences developed in patients with T3 papillomas. CONCLUSIONS The recurrence rates observed after endonasal resection are comparable to those after extranasal surgery. Thus, a primary endonasal approach does not mean any prognostic disadvantage. This approach should therefore be given preference over extranasal approaches whenever possible, because there are fewer side-effects and recovery is faster than after extranasal surgery.
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Affiliation(s)
- T Stange
- Klinik für Hals-Nasen-Ohren-Heilkunde, Kopf- und Halschirurgie, plastische Operationen, Phoniatrie und Pädaudiologie, Städtische Kliniken Neuss, Lukaskrankenhaus GmbH, Preussenstrasse 84, 41456, Neuss.
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Jurkiewicz D, Syryło A, Chomicki A, Koktysz R. [Endoscopic surgery in treatment of inverted papilloma nose et paranasal sinuses in the older patient]. Otolaryngol Pol 2007; 61:198-202. [PMID: 17668811 DOI: 10.1016/s0030-6657(07)70414-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Inverted papilloma is a benign neoplasm of uncertain ethiology. The tumour is considered locally aggressive, its tendency to invade adjacent paranasal structures and high recurrence rate causes. In this work was described one case of 102 year's old patient with unilateral nasal obstruction since 5 month and headache. Endoscopy surgery was applied. Histological examination revealed inverted papilloma.
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Affiliation(s)
- Dariusz Jurkiewicz
- Klinika Otolaryngologii, Wojskowego Instytutu Medycznego CSK MON w Warszawie
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Eggers G, Mühling J, Hassfeld S. Inverted papilloma of paranasal sinuses. J Craniomaxillofac Surg 2007; 35:21-9. [PMID: 17267229 DOI: 10.1016/j.jcms.2006.10.003] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2004] [Accepted: 10/17/2006] [Indexed: 10/23/2022] Open
Abstract
INTRODUCTION Inverted papilloma (Schneiderian papilloma) is a primarily benign lesion that occurs in the nasal cavity and paranasal sinuses. Clinical problems include a tendency towards local destruction, recurrence and malignant transformation into squamous cell carcinoma. Hence, complete surgical removal is the therapy of choice and a meticulous follow-up is mandatory. STUDY DESIGN This is a review including a short introduction to the different histological types of nasal papilloma, their pathogenesis and the clinical and histopathological diagnosis. Staging systems, therapeutic approaches, and surgical concepts are discussed. RESULT The detection and definition of factors that allow a prognosis of recurrence or malignant transformation of inverted papilloma is an active field of research. The results of studies dealing with the definition of prognostic factors, that investigated immunohistochemical methods, virus detection, molecular genetics, and histomorphological studies are discussed including our own results on the prognostic value of histology. A concept for the diagnosis, management, therapy and follow-up of inverted papilloma is proposed.
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Affiliation(s)
- Georg Eggers
- Department of Oral and Cranio-Maxillofacial Surgery, Heidelberg University Hospital, Heidelberg, Germany.
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Ozcan C, Görür K, Talas D. Recurrent inverted papilloma of a pediatric patient: clinico-radiological considerations. Int J Pediatr Otorhinolaryngol 2005; 69:861-4. [PMID: 15885343 DOI: 10.1016/j.ijporl.2005.01.033] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2004] [Revised: 12/10/2004] [Accepted: 01/06/2005] [Indexed: 10/25/2022]
Abstract
Inverted papilloma (IP) of the nasal cavity and paranasal sinuses is an uncommon pathology, especially in the pediatric population. We present a pediatric case of recurrent IP in the left nasal cavity. The physical examination of a 9-year-old girl revealed a polypoid mass filling the middle meatus in the left nasal cavity. Purulent secretion and adenoid vegetation obstructing the choanea were also noted. Coronal and axial maxillo-facial computed tomography demonstrated a mass in the nasal cavity, enlarging the left middle meatus. We discussed the imaging findings and treatment of IP and concluded that it should have been included in the differential diagnosis of nasal mass lesions in the pediatric population.
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Affiliation(s)
- Cengiz Ozcan
- Department of Otorhinolaryngology, School of Medicine, Mersin University, Findikpinari Caddesi, Bugi Sitesi, No. 28 Kuyuluk, 33200 Mersin, Turkey.
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Tomenzoli D, Castelnuovo P, Pagella F, Berlucchi M, Pianta L, Delù G, Maroldi R, Nicolai P. Different endoscopic surgical strategies in the management of inverted papilloma of the sinonasal tract: experience with 47 patients. Laryngoscope 2004; 114:193-200. [PMID: 14755188 DOI: 10.1097/00005537-200402000-00003] [Citation(s) in RCA: 95] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To demonstrate the potentials and limitations of three different endoscopic procedures employed for treatment of inverted papilloma (IP) of the sinonasal tract. STUDY DESIGN Retrospective analysis of a cohort of patients treated at two University hospitals. METHODS From January 1992 to June 2000, 47 patients with IP underwent endoscopic resection. Preoperative workup included multiple biopsies of the lesion and imaging evaluation by computed tomography or magnetic resonance imaging. Massive skull base erosion, intradural or intraorbital extension, extensive involvement of the frontal sinus, abundant scar tissue caused by previous surgery, or the concomitant presence of squamous cell carcinoma were considered absolute contraindications for a purely endoscopic approach. Three types of resection were used: ethmoidectomy with wide antrostomy and sphenoidotomy (type 1) for IPs confined to the middle meatus, medial maxillectomy with ethmoidectomy and sphenoidotomy (type 2) for IPs partially invading the maxillary sinus, and a Sturmann-Canfield operation (type 3) for IPs involving the mucosa of the alveolar recess or of the anterolateral corner of the maxillary sinus. All patients were followed by periodic endoscopic evaluations. RESULTS Type 1, 2, and 3 resections were performed in 26, 15, and 6 patients, respectively. No recurrences were observed after a mean follow-up of 55 (range 30-132) months. One patient, who underwent a type 2 resection, developed a stenosis of the lacrimal pathways requiring endoscopic dacryocystorhinostomy. CONCLUSIONS Our experience confirms that endoscopic surgery is an effective and safe method of treatment for most IPs. The availability of different endoscopic techniques allows the entity of the dissection to be modulated in relation to the extent of disease. Strict application of selection criteria, meticulous use of subperiosteal dissection in the involved areas, and regular follow-up evaluation are key elements for success.
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Affiliation(s)
- Davide Tomenzoli
- Department of Otorhinolaryngology, University of Brescia, Brescia, Italy
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Lawson W, Kaufman MR, Biller HF. Treatment outcomes in the management of inverted papilloma: an analysis of 160 cases. Laryngoscope 2003; 113:1548-56. [PMID: 12972932 DOI: 10.1097/00005537-200309000-00026] [Citation(s) in RCA: 151] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE The objective of this study is to compare the surgical options for treatment of inverted papilloma to determine the appropriate indications for conservative and aggressive management. STUDY DESIGN AND SETTING A retrospective review of 160 patients with a diagnosis of inverted papilloma treated by the two senior authors (w.l. and h.f.b.) between 1973 and 2001. RESULTS The study group consisted of 124 male and 36 female patients with an average age of 56 years. The follow-up period ranged from 10 months to 16 years (mean, 5.2 years). Seventy-eight patients (49%) had undergone prior surgery. Lateral rhinotomy was performed in 112 patients (70%), with a recurrence rate of 18%. Conservative removal was performed in 41 patients (26%), including 30 (19%) endoscopic approaches, with a recurrence rate of 12%. The remaining patients underwent midfacial degloving, osteoplastic approach, or craniofacial resection. The rate of malignant transformation was 7%. CONCLUSION We present the largest personal series of cases of inverted papilloma to date. Our data suggest that conservative approaches, especially endoscopic removal, can be performed on selected lesions with recurrence rates that are comparable to those of more aggressive techniques. Those inverted papillomas that recur after treatment may represent a subset of lesions with an inherent aggressiveness, for which optimal treatment has yet to be determined.
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Affiliation(s)
- William Lawson
- Department of Otolaryngology-Head and Neck Surgery, The Mount Sinai School of Medicine, New York, New York, USA.
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Henríquez M, Altuna X, Zulueta A, Gorostiaga F, Algaba J. [Inverted papilloma: treatment and evolution]. ACTA OTORRINOLARINGOLOGICA ESPANOLA 2003; 54:242-8. [PMID: 12825240 DOI: 10.1016/s0001-6519(03)78411-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Inverted Papilloma is a frequent bening nasosinusal tumour. The high frequency of recurrences and the malignant potential are its clinical characteristics. We present our experience in a retrospective study done in the last 10 years. 10 patients with Inverted Papilloma have been treated during that period. According to the Classification made by krouse who divides the Inverted Papilloma in four stages, we found 3 in stage I, 6 in stage II and 1 in stage IV. The treatment in almost all of the patients in Stage I and II was endonasal surgery. External approach was performed for stage IV. The recurrence rate was 30% and malignization occurred in 10% of the cases. Finally, we have compared other publications, and revised the literature.
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Affiliation(s)
- M Henríquez
- Servicio de ORL, Hospital Donostia, Apartado de Correos 477, 20080 San Sebastián
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Abstract
We report a rare case of a schneiderian papilloma of the nasopharynx. Because this tumor is locally invasive, has a tendency to recur, and can undergo malignant transformation, it should be completely excised. It is possible to completely remove such a tumor in a minimally invasive way by using a combination of transnasal and transoral approaches and high-resolution angled endoscopes and other suitably designed instruments.
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Affiliation(s)
- Wong-Kein Low
- Department of Otolaryngology, Singapore General Hospital
| | - Song-Tar Toh
- Department of Otolaryngology, Singapore General Hospital
| | - Chee-Meng Lim
- Department of Otolaryngology, Singapore General Hospital
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Abstract
OBJECTIVE To assess the surgical management of patients with inverted nasal papilloma over a 14-year period. STUDY DESIGN Retrospective study. SETTING Tertiary health care center. RESULTS Fifty-three patients (38 males, 15 females) with an average age of 49.8 years were treated. Overall recurrence rate was 28% and a malignant association of 9% was shown. Recurrence rates varied from 27% in patients with more extensive disease involvement treated by lateral rhinotomy and medial maxillectomy, to 30% in patients with less extensive disease treated conservatively. Of the 5 patients with associated malignancy, 3 (6% of all patients) are likely to have undergone malignant transformation. CONCLUSION Aggressive initial management remains the therapeutic aim in this condition.
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Affiliation(s)
- M A Thorp
- Department of Otolaryngology, University of Cape Town, Groote Schuur Hospital, Observatory, South Africa
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