Endoscopic removal of sinonasal inverted papilloma including endoscopic medial maxillectomy

Peter John Wormald, Eng Ooi, C Andrew Van Hasselt, Salil Nair

    Research output: Contribution to journalArticlepeer-review

    173 Citations (Scopus)

    Abstract

    Objectives/Hypothesis: Surgical excision is regarded as the treatment of choice for sinonasal inverted papilloma. Resection can be performed endoscopically or through an external approach. Debate exists about which approach to use. The study presents different endoscopic techniques for various tumor locations and reviews the results. Study Design: A prospective study and an integrated literature review. Methods: Seventeen consecutive patients with inverted papilloma who underwent endoscopic surgical excision, including medial maxillectomies and modified Lothrop procedures, were analyzed. Preoperative symptoms, computed tomography and magnetic resonance imaging findings, operative findings, tumor stage, and outcomes were recorded. Results: Thirteen male and four female patients presented with inverted papilloma between December 1993 and October 2001. Nasal obstruction was the most common presenting symptom (50%). Sixty-five percent of tumors were either stage II or stage III. Endoscopic resection was the primary treatment in 14 patients. Of the three patients who were secondarily treated endoscopically, one had recurrence and was subsequently found to have focus of squamous cell carcinoma. The overall recurrence rate was 6% and the incidence of malignancy was 6% (1 of 17). Recurrence rate for primary resections was zero (0 of 14). Five patients underwent endoscopic medial maxillectomies, and one patient with frontal sinus inverted papilloma was successfully treated with a modified endoscopic Lothrop procedure. Conclusions: Endoscopic sinus surgery is a viable treatment alternative for sinonasal inverted papilloma. Recurrence rates for primary treatment are comparable to external approaches. Close follow-up of patients is mandatory because recurrence may be associated with malignancy. Key Words: Endoscopic, inverted papilloma, medial maxillectomy.Laryngoscope,113:867– 873, 2003
    Original languageEnglish
    Pages (from-to)867-873
    Number of pages7
    JournalLaryngoscope
    Volume113
    Issue number5
    DOIs
    Publication statusPublished - 2003

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