Background: Sinonasal inverted papillomas (SNIPs) are benign epithelial growths with high recurrence rates after surgical management. This study aims to evaluate SNIP recurrence rates after endoscopic surgery and to provide a comparison of published staging systems. Methods: This chart review evaluated primary and revision SNIP cases from January 2008 to December 2016 at a tertiary sinus centre. Data was collected on patient demographics, origin site, surgical approaches, follow-up duration, recurrence, and smoking history. Each case was staged using Krouse, Oikawa, Cannady, Han, and Kamel systems. Results: 52 primary and 22 revision SNIP patients had a mean follow-up of 42.3 (range:3-55) months. 11 primary cases (21.1%) and 5 revision cases (22.7%) had recurrences. Primary and revision cases had a mean time to recurrence of 24.0 (range:3-55) and 14.6 (range:10-20) months respectively. Smoking history had an OR of 0.63 (CI 95%: 0.18-2.22) for recurrence. The age group of 20-39 years featured the highest rates of recurrence. Patient groups defined by each staging system were compared by Kaplan-Meier survival analyses and logrank tests. Chi-squared values for Krouse, Oikawa, Cannady, Han, and Kamel systems were 6.73 (p>0.05), 7.02 (p>0.05), 6.19 (p=0.045), 8.23 (p=0.042) and 3.29 (p>0.05) respectively. Conclusion: Recurrence rates found in this study are comparable to published literature. No statistical significance was found to associate smoking with recurrence. Han and Cannady staging systems were found to define patient groups that correlated well with recurrence. Staging systems should play a role in the management of SNIPs, especially to identify patients requiring additional post-surgical monitoring.
The impact of predation by juvenile chum Oncorhynchus keta (Walbaum) and pink 0. gorbuscha (Walbaum) salmon on harpacticoid copepods inhabiting a shallow subtidal seagrass Zostera marina L, bed on Roberts Bank, British Columbia, Canada, was examined. Previous studies of the impact of juvenile salmonid predation on harpacticoid communities have yielded contradictory results and have been based on indirect and weak evidence. The influence of salmon predation on the dynamics of the copepod community was examined by comparing patterns of copepod mortality to patterns of salmonid consumption. Samples of Zostera leaves and underlying sedment were collected at ca 2 wk intervals from late January to early July in 1986 and 1987 for estimation of harpacticoid copepod abundance. Collections for estimation of juvenile salmonid abundance and gut contents were made concurrently at a low tide refuge adjacent to the seagrass bed. Juvenile chum and pink salmon were found mainly to consume 3 harpacticoid copepod species (> 75 % by number in gut contents in both years): Harpacticus uniremis Kroyer, Tisbe cf. furcata (Baird) and Zaus aurelii Poppe. Using a simple and robust deterministic, cornpartmental population dynamics model, mortality of adults and potential adults of these 3 species between sampling dates was estimated. In comparison with an index of consumption estimated for the salmonid population, temporal patterns of copepod mortality generally did not correspond to temporal patterns of salmonid consumption. This lack of correspondence indicates salmonid consumption did not cause observed declines in H. uniremis. T. cf. furcata and Z. aurelii abundance during the sampling season in either year.
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