Endoscopic surgical management of sinonasal inverted papilloma extending to the frontal sinuses

2016 ◽  
Vol 70 (6) ◽  
pp. 26-31 ◽  
Author(s):  
Yukiko Takahashi ◽  
Fumi Shoji ◽  
Yukio Katori ◽  
Hiroshi Hidaka ◽  
Naoya Noguchi ◽  
...  
Keyword(s):  
Surgical Management ◽  
Endoscopic Surgery ◽  
Late Complications ◽  
Inverted Papilloma ◽  
Surgical Approaches ◽  
Sinonasal Inverted Papilloma ◽  
Endoscopic Guidance ◽  
Frontal Sinuses ◽  
Draf Iii

Objective: Sinonasal inverted papilloma has been traditionally managed with external surgical approaches. Advances in imaging guidance systems, surgical instrumentation, and intraoperative multi-visualization have led to a gradual shift from external approaches to endoscopic surgery. However, for anatomical and technical reasons, endoscopic surgery of sinonasal inverted papilloma extending to the frontal sinuses is still challenging. Here, we present our experience in endoscopic surgical management of sinonasal inverted papilloma extending to one or both frontal sinuses. Methods: We present 10 cases of sinonasal inverted papilloma extending to the frontal sinuses and successfully removed by endoscopic median drainage (Draf III procedure) under endoscopic guidance without any additional external approach. Results: The whole cavity of the frontal sinuses was easily inspected at the end of the surgical procedure. No early or late complications were observed. No recurrence was identified after an average follow-up period of 39.5 months. Conclusion: Use of an endoscopic median drainage approach to manage sinonasal inverted papilloma extending to one or both frontal sinuses is feasible and seems effective.

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

2017 ◽  
Vol 31 (1) ◽  
pp. 51-55 ◽  
Author(s):  
Xiao-Dan Jiang ◽  
Qing-Zhe Dong ◽  
Shen-Ling Li ◽  
Tian-Qiao Huang ◽  
Nian-Kai Zhang
Keyword(s):  
Recurrence Rate ◽  
Endoscopic Surgery ◽  
Inverted Papilloma ◽  
Surgical Strategy ◽  
Endoscopic Endonasal Approach ◽  
Endonasal Approach ◽  
Endoscopic Endonasal ◽  
Sinonasal Inverted Papilloma ◽  
Significant Difference

Background Sinonasal inverted papilloma (SNIP) is noted for its high rate of recurrence and malignant transformation. Although many clinical studies have demonstrated the effectiveness of the endoscopic approach for SNIP, the surgical strategy has been the subject of much debate. Objective To evaluate the effectiveness of the endoscopic endonasal approach in SNIP. Methods A systematic review of patients with a diagnosis of SNIP and who had surgery at our institution from June 2005 to March 2013 was performed. All the patients who had postoperative follow-up for >2 years were enrolled. Each case was categorized into one of four stages as reported by Krouse. Demographic and tumor date, operative approach, complications, and recurrence rates were collected. Results A total of 125 patients were included in this study. There were 17 patients in stage 1, 40 in stage 2, 57 in stage 3, and 11 in stage 4. The overall recurrence rate was 8.0%. There was no significant difference in recurrence among the stages (all p > 0.05). Recurrence after endoscopic endonasal approach (8.4%) and a combined endoscopic and open exposure procedure (5.6%) were not significantly different (p > 0.05). The recurrence rate was significantly (p < 0.05) higher in patients with revision (15.6%) than in patients in the primary cases (3.8%). A common site of tumor origin was recorded to be from the maxillary sinus (40.2%). Twenty percent of recurrences were observed up to 5 years after surgery. Conclusion 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.

scholarly journals The comparison of endoscopic and external surgical approaches for sinonasal inverted papilloma and their impact on tumour recurrence

2019 ◽  
Vol 8 (4) ◽  
pp. 90-95
Author(s):  
Zuzanna Nowinka ◽  
Shadaba Ahmed
Keyword(s):  
Recurrence Rate ◽  
Endoscopic Surgery ◽  
Surgical Complications ◽  
Inverted Papilloma ◽  
Endoscopic Approach ◽  
High Rate ◽  
Surgical Approaches ◽  
Tumour Resection ◽  
External Approach ◽  
Sinonasal Inverted Papilloma

Introduction: Sinonasal inverted papilloma (SNIP) is a rare, benign tumour originating from the mucosal lining of the sinonasal cavity. The treatment is aimed at complete tumour resection. Current resection methods include external excision, endoscopic surgery and a combined approach. The high rate of SNIP recurrence poses a challenge for the ear nose and throat (ENT) specialist. There is a debate about which method provides the best outcomes. In this study, the most recent literature is analysed to evaluate the effectiveness of each surgical approach in terms of recurrence rate and surgical complications. Results: The literature search yielded data for 941 patients from ten studies. The analysis showed a recurrence rate of 13.5% for the endoscopic approach, 34% for combined and 36.7% for the external. The lowest recurrence rate (0%-3.6%) was reported when novel endoscopic approaches, such as prelacrimal recess or ‘TuNa’ saving, were used. However, the comparison of surgical complications was challenging due to inconsistent reporting. Discussion: The external approach previously considered a ‘gold standard’ is now becoming replaced by endoscopic surgery. The advantages of an endoscopic approach are a lower recurrence rate, better visualisation of the tumour and a more precise excision. Moreover, this approach preserves the surrounding tissues, reducing the amount of complications and recovery time. However, the external approach should still be employed when SNIP is widespread or in proximity with vital structures. Careful pre-operative planning is needed as the primary surgery has the best chances of eliminating the disease. Each revision surgery subsequently increases the risk of SNIP recurrence. Furthermore, there is a need for agreement on minimal surveillance time after SNIP resection. Conclusion: The endoscopic approach should be a mainstay of SNIP treatment due to low recurrence rate and better patient outcomes. Nevertheless, ENT specialists should keep in mind that for more advanced disease, external an combined methods may be more appropriate.

scholarly journals Endoscopic Resection of Sinonasal Inverted Papilloma: A Multivariate Retrospective Analysis of Factors Affecting Recurrence and Persistence

2019 ◽  
pp. 014556131989045 ◽  
Author(s):  
Antonio Minni ◽  
Roberto Gera ◽  
Chiara Bulgheroni ◽  
Massimo Ralli ◽  
Fabrizio Cialente ◽  
...  
Keyword(s):  
Risk Factors ◽  
Inverted Papilloma ◽  
Surgical Approaches ◽  
Surgical Removal ◽  
Epithelial Tumor ◽  
Factors Affecting ◽  
Sinonasal Inverted Papilloma ◽  
Disease Site ◽  
Clinical Records

Sinonasal inverted papilloma (IP) is the most common benign epithelial tumor in the nasal cavity and paranasal sinuses, with a worldwide incidence between 0.6 and 1.5/100 000 persons per year. However, only a few studies have investigated patient-dependent factors related to IP recurrence and persistence. According to available evidence, these factors are still debated, and results are contradictory. In this multicenter retrospective study, we analyzed the clinical records of 130 patients who were surgically treated for sinonasal IP to evaluate the factors affecting recurrence and persistence of IP and compared the curative rates of different surgical approaches. Our analysis showed that IP recurrence is strongly related to specific risk factors including incomplete surgical removal, stage of disease, site of the lesion, surgical technique, and malignancy rate. In conclusion, the recurrence of IP may be affected by several risk factors; these factors must be carefully considered during clinical evaluation and especially during the follow-up of patients with IP.

scholarly journals Sinonasal inverted papilloma: Recurrence, surgical management, and mini review

2021 ◽  
Vol 17 (2) ◽  
pp. 81-85
Author(s):  
Mehmet Emrah Ceylan ◽  
◽  
Abdullah Dalgic ◽  
Aynur Aliyeva ◽  
Deniz Tuna Edizer ◽  
...  
Keyword(s):  
Surgical Management ◽  
Inverted Papilloma ◽  
Sinonasal Inverted Papilloma

Clinical Implications of Carcinoma In Situ in Sinonasal Inverted Papilloma

2019 ◽  
Vol 161 (6) ◽  
pp. 1036-1042 ◽  
Author(s):  
Ivy W. Maina ◽  
Charles C. L. Tong ◽  
Esther Baranov ◽  
Neil N. Patel ◽  
Vasiliki Triantafillou ◽  
...  
Keyword(s):  
Malignant Transformation ◽  
Recurrence Rate ◽  
Carcinoma In Situ ◽  
Inverted Papilloma ◽  
Sinonasal Inverted Papilloma ◽  
Definitive Surgery ◽  
Severe Degree ◽  
Multiple Recurrences

Objective Sinonasal inverted papilloma (IP) is a typically benign sinonasal tumor with a tendency to recur and the potential for malignant transformation. Varying degrees of dysplasia may be present, of which carcinoma in situ (CIS) is most advanced. We hereby describe the biological and clinical behavior of IP with CIS (IPwCIS). Study Design Retrospective cohort. Setting Tertiary academic referral center. Subjects and Methods Patients who underwent surgical resection for IP between 2002 and 2017. Pertinent clinical data were obtained, and all IPwCIS cases were histologically confirmed. Results In total, 37 of 215 cases (17.2%) were identified with IPwCIS. Mean age was 57 years and 86.5% of patients were male. Median follow-up was 82 months, and the recurrence rate was 27%. The maxillary sinus was the most common primary site (37.8%) and 14 tumors (37.8%) demonstrated multifocal attachment, which was associated with recurrence (odds ratio [OR], 9.7; 95% confidence interval [CI], 1.4-112.8; P = .028). IPwCIS was also associated with multiple recurrences (OR, 2.71; 95% CI, 1.246-5.814; P = .021). Most patients were treated with surgery alone (89.1%) and 4 patients received adjuvant radiotherapy (8.1%). Only 1 patient (2.7%) demonstrated malignant transformation after definitive surgery. Conclusions IPwCIS represents the most severe degree of dysplasia prior to malignant transformation and is associated with higher recurrence rate and multifocal involvement but low rate of conversion to invasive carcinoma. The need for adjuvant therapy remains controversial, and further research into the etiology of the disease is warranted.

scholarly journals Risk Factors of Recurrence and Malignant Transformation of Sinonasal Inverted Papilloma

2017 ◽  
Vol 2017 ◽  
pp. 1-7 ◽  
Author(s):  
Marta Gamrot-Wrzoł ◽  
Paweł Sowa ◽  
Grażyna Lisowska ◽  
Wojciech Ścierski ◽  
Maciej Misiołek
Keyword(s):  
Malignant Transformation ◽  
Clinical Medicine ◽  
Surgical Techniques ◽  
Diagnostic Techniques ◽  
Postoperative Management ◽  
Inverted Papilloma ◽  
Surgical Approaches ◽  
Ki 67 ◽  
Wnt Proteins ◽  
Sinonasal Inverted Papilloma

Sinonasal inverted papilloma is a relatively rare disease; however, it is prevalent enough for every ENT practitioner to encounter it several times throughout medical routines. Despite the developments in experimental and clinical medicine as well as surgical techniques, our knowledge of this disease is still inadequate. With improved imaging and better diagnostic techniques, proper diagnosis and qualification for surgical approaches leave no doubt. Although the endoscopic approach seems to be the gold standard for such condition, some cases may additionally require an external approach. Regardless of the type of surgery, postoperative management is crucial for both healing and long-term follow-up. Unfortunately, the procedures are still lacking in explicit and standardized postoperative management guidelines. Moreover, an important issue is still the need for a biomarker indicative of inverted papilloma and its malignant transformation. Several particles, within the spotlight of the researchers, have been SCCA, Ki-67, Bcl-2, Wnt proteins, and many more. Nevertheless, the topic requires further investigations.

Primary temporal inverted papilloma with premalignant change

2010 ◽  
Vol 125 (2) ◽  
pp. 206-209 ◽  
Author(s):  
H Zhou ◽  
Z Chen ◽  
H Li ◽  
G Xing
Keyword(s):  
Recurrence Rate ◽  
Radical Resection ◽  
Therapeutic Strategies ◽  
Inverted Papilloma ◽  
Sinonasal Inverted Papilloma ◽  
Sinonasal Papilloma

AbstractObjectives:To explore the pathology, diagnosis, therapeutic strategies and prognosis of primary temporal inverted papilloma.Methods:We present one of the first reported cases of primary temporal inverted papilloma with premalignant change. The available data are reviewed.Results:To the best of our knowledge, only 10 evaluable cases of this tumour have been reported. The recurrence rate is higher for this tumour than for sinonasal inverted papilloma.Conclusion:Primary temporal inverted papilloma is extremely rare, and its diagnosis should be made only following clinical exclusion of sinonasal papilloma. Therapy mainly comprises radical resection of the lesion, and long-term post-operative follow up is mandatory.

scholarly journals Surgical Management of Sinonasal Inverted Papilloma

2010 ◽  
Vol 49 (2) ◽  
pp. 132-137 ◽  
Author(s):  
Kazumi Yoshino ◽  
Akihiro Katada ◽  
Akihiro Katayama ◽  
Miki Takahara ◽  
Isamu Kunibe ◽  
...  
Keyword(s):  
Surgical Management ◽  
Inverted Papilloma ◽  
Sinonasal Inverted Papilloma

Comparison of Current Staging Systems for Sinonasal Inverted Papilloma

2020 ◽  
Vol 35 (1) ◽  
pp. 64-71
Author(s):  
Tsuguhisa Nakayama ◽  
Yasuhiro Tsunemi ◽  
Takashi Kashiwagi ◽  
Akihito Kuboki ◽  
Shuchi Yamakawa ◽  
...  
Keyword(s):  
Disease Free Survival ◽  
Staging System ◽  
Inverted Papilloma ◽  
Machine Learning Algorithms ◽  
Recurrence Rates ◽  
Cox Proportional Hazard ◽  
Sinonasal Inverted Papilloma ◽  
Staging Systems ◽  
Cox Proportional Hazard Models

Background A staging system is essential for determining the optimal surgical approach and predicting postoperative outcomes for inverted papilloma (IP). Although staging systems based on the extent to which the location is occupied by an IP have been widely used, an origin site-based classification of IP using unsupervised machine learning algorithms has recently been reported. Objective To determine the most appropriate of five staging systems for sinonasal IP by comparing recurrence rates for each stage according to each of those systems. Methods Eighty-seven patients with sinonasal IP were enrolled in the study. Their tumors were retrospectively categorized according to the Krouse, Oikawa, Cannady, and Han staging systems, which are based on the extent of IP, and the Meng system, which is based on the site of origin. The rates of recurrence for each stage of the five systems were compared. Results Seven of the 87 patients (8.0%) had recurrences during an average 45.5 months (12–138 months) of follow-up. There were significant differences in disease-free survival between the stages specified by Han and Meng (p = 0.027 and p < 0.001, respectively), but not between the stages specified by Krouse, Oikawa, and Cannady (p = 0.236, 0.062, and 0.130, respectively). Cox proportional hazard models revealed that Meng system (adjusted hazard ratio [aHR] 4.32, 95% confidence interval [CI] 1.10–17.04) and presence of dysplasia (aHR 7.42, 95% CI 1.15–47.85) were significantly associated with recurrence. Conclusion The staging systems proposed by Han and Meng were found to be accurate in terms of tumor recurrence. We recommend use of the Han staging system before surgery and the Meng system after intraoperative identification of the origin of the tumor.

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