Need for long‐term follow‐up in sinonasal inverted papilloma: A Single‐institution experience

Abstract

Background: Most studies on sinonasal inverted papillomas (SNIPs) regarding risk factors for recurrence, recurrence rates (RRs) and malignant transformation are biased by a significant proportion of revision cases. Methods: Retrospective study on patients with consecutive, treatment-naïve SNIPs at a tertiary referral center between 1999 and 2019. Results: Overall, RR was 9.8% (10 of 102 patients), with 2 of 10 recurrences (20%) occurring after more than 5 years. Histopathological workup revealed synchronous malignancy in 2 of 102 patients (2%). Subgroup analysis revealed a significantly higher RR for SNIPs involving the frontal sinus (26.3% vs 6.0%, P = .02). No SNIPs primarily originating from the frontal sinus were observed. Conclusion: Overall, RR of treatment-naïve SNIPs is comparably low; however, long-term follow-up is mandatory due to late recurrences. Secondary involvement of the frontal sinus was identified as risk factor for recurrence. No SNIPs primarily originating from frontal sinus were observed.

Surgical treatment of sinonasal inverted papilloma

“…Current trends propose subperiosteal dissection and removal of the mucosa and bipolar cauterization in addition to drilling, curettage and removal of the bone underneath at site of attachment of SNIP to ensure complete excision [11,19,20,36 ▪ ,38].…”

“…Recurrences usually occur within 2 years postoperatively and long-term follow-up is mandatory [20,38].…”

Eficacia del tratamiento quirúrgico del papiloma invertido nasosinusal

“…El seguimiento estrecho en consulta y la exploración endoscópica periódica pueden disminuir la recurrencia y evitar, de este modo, la malignización [24]. Nuestro estudio está exento de carcinomas, coincidiendo con numerosos artículos publicados [5,[25][26][27][28][29]. Podría asociarse con una mayor tasa de malignización un diagnóstico tardío, un retraso en el tratamiento o diferentes subtipos de papilomas [1,30].…”

International Consensus Statement on Allergy and Rhinology: Sinonasal Tumors

“…The majority of recurrent IP lesions arise within the first year following resection and often occur in the same anatomic location as the primary lesion; however, 20% of recurrences will occur after 5 years postoperatively 739 . Given this potential for late recurrence and potential metachronous malignant transformation, IP follow‐up duration and modalities should include routine endoscopic evaluation or MRI in lesions not easily seen endoscopically for a minimum of 5 years postoperatively, followed by recommended lifetime follow‐up 736,740 …”