The endoscopic management of sinonasal inverted papillomas 1

Abstract

Sinonasal inverted papillomas are well known for high recurrence rates after surgery and the risk of malignant change. Recurrent disease occurs because of inadequate excision as a result of poor exposure and visualization. For these reasons, aggressive surgery has been advocated-classically a lateral rhinotomy and en bloc medial maxillectomy. Endoscopic techniques have provided excellent visualization and a less invasive approach to these tumours. We describe 18 patients with inverted papillomas treated endoscopically at the Singapore General Hospital since 1993. The presentation, sites of involvement and diagnostic imaging are presented. All the patients had a minimum follow-up of 18 months with a mean of 32.8 months. One case of recurrence at the frontal recess is reported. Endoscopic management is appropriate for the diagnosis, follow-up and treatment of circumscribed primary and recurrent inverted papillomas.

Current advances in the basic research and clinical management of sinonasal inverted papilloma (Review)

“…These are all quite rare. On review, the lateral wall of the nasal fossa and the maxillary sinus are the most frequent sites of origin for IP, whereas its exclusive localization to the frontal (26,70) or sphenoid sinus (71,72) is exceedingly rare and, when involved, is usually caused by an invasion from adjacent sites. Likewise, the intracranial invasion of IP is a rare event, which has been mostly noted at the level of the cribriform plate or the ethmoid roof area in recurrent lesions (73).…”

“…There is only 1 reported case of such malignant transformation (25). ii) IPs however, (ICD-O 8121/1), arising primarily in the paranasal sinuses show malignant transformation or coexisting carcinomas in 0% (26)(27)(28)(29) to 53% (30) in certain studies with great variations in the numbers of treated patients. iii) Columnar cell papilloma (cylindrical cell papilloma, ICD-O 812171) is the least common type of nasal papilloma.…”

“…The incidence of focal malignancy within IP or a site adjacent to the papilloma ranges from 0 to 53% (26)(27)(28)(29)(30). An association between IP and SCC as high as 53% is likely to be overestimated.…”

Treatment Of Bilateral Squamous Cell Carcinoma Of The Paranasal Sinuses Using Bilateral Lateral Rhinotomies

“…Malign transformasyon izlenen olgular genis radikal cerrahi yaklasımlarla tedavi edilmelidir. Bilateral görülme sıklığı %0-13 olarak rapor edilmistir [15][16][17][18]. Bilateral nazal tutulum, nazal kavitenin bir tarafındaki tümörün nazal septumu invaze ederek karşı taraf nazal kaviteye geçtiği düsünülmektedir [19].…”

Bilateral inverted papilloma: A report of two cases and review of the current literature

“…However, over the last decade many reports have emerged using endoscopic techniques [9,[19][20][21][22] with rates of recurrence averaging out at 13.4%. A trend towards utilizing the improved endoscopic technology, including navigational systems, has slowly emerged [23].…”