Evolution of endoscopic surgery in the treatment of inverted papilloma

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.

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Applicability of Biomarkers for Differentiation of Inverted Papilloma Assigned for Endoscopic Surgery

Trends in Medical Research ◽

10.3923/tmr.2013.16.26 ◽

2013 ◽

Vol 8 (1) ◽

pp. 16-26

Author(s):

Mohammad M. Fatthy ◽

Ahmed Abd Elrahman Mahmoud ◽

Ahmed M. Abdelhady Elsheikh ◽

Hatem Salah Eldin Elha

Keyword(s):

Endoscopic Surgery ◽

Inverted Papilloma

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Endoscopic surgery to treat inverted papilloma: which are the limits?

Brazilian Journal of Otorhinolaryngology ◽

10.5935/1808-8694.20130050 ◽

2013 ◽

Vol 79 (3) ◽

pp. 275

Author(s):

Erika Ferreira Gomes

Keyword(s):

Endoscopic Surgery ◽

Inverted Papilloma

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Endoscopic Surgery of Inverted Papillomas under Image Guidance—A Prospective Study of 42 Consecutive Cases at a Danish University Clinic

Otolaryngology ◽

10.1016/j.otohns.2005.01.016 ◽

2005 ◽

Vol 132 (4) ◽

pp. 602-607 ◽

Cited By ~ 27

Author(s):

Christian Von Buchwald ◽

Anders S. Von Larsen

Keyword(s):

Endoscopic Resection ◽

Endoscopic Surgery ◽

Image Guidance ◽

Inverted Papilloma ◽

Treatment Morbidity ◽

Long Term Follow Up ◽

Associated Malignancy ◽

A Prospective Study ◽

Inverted Papillomas

BACKGROUND: To evaluate the feasibility of endoscopic surgery with image guidance in the treatment of inverted papillomas. STUDY DESIGN AND SETTING: This prospective cohort study comprised 42 consecutive patients with biopsy-confirmed inverted papillomas that were diagnosed between 1998 and 2003. All patients were treated by the first author (C.B.). Image guidance based on preacquired CT scans of the patients was used to assist the surgeon aiming at endoscopic resection of inverted papilloma. The success of the surgery was judged primarily by the recurrence rate and the treatment morbidity. RESULTS: The study group consisted of 30 males and 12 females with a median age of 61 years. The follow-up period ranged from 9 months to 69 months (median, 37 months). The only additional procedure performed was the Caldwell-Luc procedure (8 cases). Recurrence was diagnosed in 10 cases (24%), all in the original tumor site. Eight of these had undergone previous surgery for inverted papilloma. The recurrences were predominantly located in the maxillary or in the frontal sinus (8 cases). In 2 cases, the recurrence was simply removed endoscopically while performing the biopsy procedure. All recurrences were identified within the first 9 months. Associated malignancy was not shown. No severe complications occurred. CONCLUSIONS: A treatment based on endoscopic resection with image guidance appears to offer a safe treatment modality of inverted papilloma with insignificant morbidity. Predominantly cases with nonmedial involvement of the maxillary sinus still require a supplement with the Caldwell Luc procedure. Although all the recurrences were found within 9 months postoperatively, later recurrences cannot be excluded. Long-term follow-up is recommended.

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

Otolaryngologia Polska ◽

10.5604/01.3001.0009.3801 ◽

2016 ◽

Vol 70 (6) ◽

pp. 26-31 ◽

Cited By ~ 5

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.

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