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Plou P, Serioli S, Alexander AY, Leonel LCPC, Peris-Celda M, Pinheiro-Neto CD. Full-Extension Eyebrow Approach with Supraorbital Nerve Preservation for Frontal Sinus Tumors. Laryngoscope 2024; 134:1633-1637. [PMID: 37676076 DOI: 10.1002/lary.31011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 07/18/2023] [Accepted: 08/07/2023] [Indexed: 09/08/2023]
Abstract
Frontal sinus surgery still represents a challenge due to its complex and highly variable anatomy. In this manuscript, we present a detailed anatomical description of an eyebrow approach that allows full exposure of the frontal sinus with a large osteoplastic bone flap and preservation of the supraorbital nerve. Laryngoscope, 134:1633-1637, 2024.
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Affiliation(s)
- Pedro Plou
- Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota, USA
- Department of Neurosurgery and Department of Otolaryngology - Head and Neck Surgery, Mayo Clinic Rhoton Neurosurgery and Otolaryngology Surgical Anatomy Program, Rochester, Minnesota, USA
- Department of Neurosurgery, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - Simona Serioli
- Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota, USA
- Department of Neurosurgery and Department of Otolaryngology - Head and Neck Surgery, Mayo Clinic Rhoton Neurosurgery and Otolaryngology Surgical Anatomy Program, Rochester, Minnesota, USA
- Division of Neurosurgery, Department of Medical and Surgical Specialties, Radiological Sciences And Public Health, University of Brescia, Brescia, Italy
| | - Alex Y Alexander
- Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota, USA
- Department of Neurosurgery and Department of Otolaryngology - Head and Neck Surgery, Mayo Clinic Rhoton Neurosurgery and Otolaryngology Surgical Anatomy Program, Rochester, Minnesota, USA
| | - Luciano C P C Leonel
- Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota, USA
- Department of Neurosurgery and Department of Otolaryngology - Head and Neck Surgery, Mayo Clinic Rhoton Neurosurgery and Otolaryngology Surgical Anatomy Program, Rochester, Minnesota, USA
| | - Maria Peris-Celda
- Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota, USA
- Department of Neurosurgery and Department of Otolaryngology - Head and Neck Surgery, Mayo Clinic Rhoton Neurosurgery and Otolaryngology Surgical Anatomy Program, Rochester, Minnesota, USA
- Department of Otorhinolaryngology Head and Neck Surgery Mayo Clinic, Rochester, Minnesota, USA
| | - Carlos D Pinheiro-Neto
- Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota, USA
- Department of Neurosurgery and Department of Otolaryngology - Head and Neck Surgery, Mayo Clinic Rhoton Neurosurgery and Otolaryngology Surgical Anatomy Program, Rochester, Minnesota, USA
- Department of Otorhinolaryngology Head and Neck Surgery Mayo Clinic, Rochester, Minnesota, USA
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2
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Cho S, Kim SG, Han DH, Kim HJ, Kim J, Kim D, Rhee C, Won T. Treatment outcome and prognostic factors of inverted papilloma involving the frontal sinus. Laryngoscope Investig Otolaryngol 2024; 9:e1206. [PMID: 38362197 PMCID: PMC10866576 DOI: 10.1002/lio2.1206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 11/12/2023] [Accepted: 12/03/2023] [Indexed: 02/17/2024] Open
Abstract
Objectives This study aimed to evaluate the characteristics and treatment outcomes of inverted papillomas involving the frontal sinus. Methods Patients treated for inverted papilloma involving the frontal sinus between 2003 and 2020 were reviewed. Tumors were classified based on their extent (Extent 1: partially encroaching on the frontal sinus; Extent 2: completely filling the frontal sinus; Extent 3: eroding bony borders beyond the frontal sinus) and site of origin (Origin 1: originating outside the frontal sinus and prolapsing into the frontal sinus; Origin 2: originating from the frontal sinus walls medial to the vertical plane of the lamina papyracea; Origin 3: originating from the frontal sinus walls lateral to the vertical plane of the lamina papyracea). Treatment outcomes including tumor recurrence and patency of the frontal recess were analyzed according to tumor characteristics and surgical treatment modalities. Results A total of 49 surgical cases were analyzed. Extent 1 were the most common type (n = 27), followed by Extent 2 (n = 15), and Extent 3 (n = 7). The most common sites of origin were Origin 1 (n = 23), followed by Origin 2 (n = 15), and Origin 3 (n = 11). Overall, there were nine recurrences (18.4%). Recurrence was not associated with tumor extent, whereas tumor origin, particularly Origin 3 was associated with higher recurrence; 1/23 (4.3%) for Origin 1, 3/15 (20.0%) for Origin 2, and 5/11 (45.5%) for Origin 3 (Log-rank p < .001). Draf III frontal sinusotomy was associated with in the highest patency rate (84.6%) during the follow-up. Conclusion The recurrence rate of frontal sinus inverted papilloma depends on tumor origin rather than the extent of the tumor. In particular, lesions originating from the frontal sinus lateral to the lamina papyracea recur frequently. Draf III frontal sinusotomy can achieve patent frontal recess allowing active surveillance. Level of Evidence IV.
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Affiliation(s)
- Sung‐Woo Cho
- Department of Otorhinolaryngology‐Head and Neck Surgery, Seoul National University Bundang HospitalSeoul National University College of MedicineSeongnamSouth Korea
| | - Su Geun Kim
- Department of Otorhinolaryngology‐Head and Neck Surgery, Seoul National University Bundang HospitalSeoul National University College of MedicineSeongnamSouth Korea
- Department of Otorhinolaryngology Head and Neck Surgery, Seoul National University HospitalSeoul National University College of MedicineSeoulSouth Korea
| | - Doo Hee Han
- Department of Otorhinolaryngology Head and Neck Surgery, Seoul National University HospitalSeoul National University College of MedicineSeoulSouth Korea
| | - Hyun Jik Kim
- Department of Otorhinolaryngology Head and Neck Surgery, Seoul National University HospitalSeoul National University College of MedicineSeoulSouth Korea
| | - Jeong‐Whun Kim
- Department of Otorhinolaryngology‐Head and Neck Surgery, Seoul National University Bundang HospitalSeoul National University College of MedicineSeongnamSouth Korea
- Research Center for Sensory OrgansSeoul National University Medical Research CenterSeoulSouth Korea
| | - Dong‐Young Kim
- Department of Otorhinolaryngology Head and Neck Surgery, Seoul National University HospitalSeoul National University College of MedicineSeoulSouth Korea
| | - Chae‐Seo Rhee
- Department of Otorhinolaryngology‐Head and Neck Surgery, Seoul National University Bundang HospitalSeoul National University College of MedicineSeongnamSouth Korea
- Department of Otorhinolaryngology Head and Neck Surgery, Seoul National University HospitalSeoul National University College of MedicineSeoulSouth Korea
- Research Center for Sensory OrgansSeoul National University Medical Research CenterSeoulSouth Korea
| | - Tae‐Bin Won
- Department of Otorhinolaryngology‐Head and Neck Surgery, Seoul National University Bundang HospitalSeoul National University College of MedicineSeongnamSouth Korea
- Department of Otorhinolaryngology Head and Neck Surgery, Seoul National University HospitalSeoul National University College of MedicineSeoulSouth Korea
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Yu S, Grose E, Lee DJ, Wu V, Pellarin M, Lee JM. Evaluation of inverted papilloma recurrence rates and factors associated recurrence after endoscopic surgical resection: a retrospective review. J Otolaryngol Head Neck Surg 2023; 52:34. [PMID: 37106391 PMCID: PMC10134596 DOI: 10.1186/s40463-023-00638-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Accepted: 03/30/2023] [Indexed: 04/29/2023] Open
Abstract
BACKGROUND Sinonasal inverted papillomas (IP) are benign tumours arising from the mucosal lining of the nasal cavity and paranasal sinuses with a high propensity for recurrence and malignant transformation. Advances in endoscopic surgery and improved radiologic navigation have increased the role of endoscopic surgical resection in the treatment of IPs. The current study aims to evaluate the rate of IP recurrence after endoscopic endonasal resection and to evaluate factors which impact recurrence. METHODS This was a single-centre retrospective chart review of all patients who underwent endoscopic sinus surgery for management of IP between January 2009 and February 2022. Primary outcomes were the rate of IP recurrence and time to IP recurrence. Secondary outcome measures were patient and tumour factors that contributed to IP recurrence. RESULTS Eighty-five patients were included. The mean age was 55.7 and 36.5% of patients were female. The mean follow-up time was 39.5 months. Of the 85 cases, 13 cases (15.3%) had recurrence of their IP and the median time to recurrence was 22.0 months. All recurrent tumours recurred at the attachment site of the primary tumour. The univariate analysis did not identify any significant demographic, clinical, or surgical predictors of IP recurrence. There were no significant changes in sinonasal symptoms at the time IP recurrence was detected. CONCLUSION Endoscopic endonasal resection of IPs represents an effective surgical approach, however, the relatively high rate of recurrence and lack of symptomatic changes at the time of recurrence necessitates long term follow up. Better delineation of risk factors for recurrence can help identify high-risk patients and inform postoperative follow up strategies.
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Affiliation(s)
- Sheila Yu
- Division of Rhinology, Department of Otolaryngology - Head and Neck Surgery, St. Michael's Hospital, Unity Health Toronto, University of Toronto, 30 Bond Street, 8 Cardinal Carter Wing, Toronto, ON, M5B 1W8, Canada
| | - Elysia Grose
- Division of Rhinology, Department of Otolaryngology - Head and Neck Surgery, St. Michael's Hospital, Unity Health Toronto, University of Toronto, 30 Bond Street, 8 Cardinal Carter Wing, Toronto, ON, M5B 1W8, Canada
| | - Daniel J Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Vincent Wu
- Division of Rhinology, Department of Otolaryngology - Head and Neck Surgery, St. Michael's Hospital, Unity Health Toronto, University of Toronto, 30 Bond Street, 8 Cardinal Carter Wing, Toronto, ON, M5B 1W8, Canada
| | - Mitchell Pellarin
- Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
| | - John M Lee
- Division of Rhinology, Department of Otolaryngology - Head and Neck Surgery, St. Michael's Hospital, Unity Health Toronto, University of Toronto, 30 Bond Street, 8 Cardinal Carter Wing, Toronto, ON, M5B 1W8, Canada.
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4
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Romano A, Audino G, Abbate V, Dell’Aversana Orabona G, Salzano G, Seidita F, Sani L, Iaconetta G, Califano L. Combined Endonasal Endoscopic and Sub-brow Orbitotomy Access to Manage a Lateral Extending Frontal Sinus Inverting Papilloma with Endo-orbital Invasion: A Case Report. Indian J Otolaryngol Head Neck Surg 2022; 74:1510-1513. [PMID: 36452793 PMCID: PMC9702497 DOI: 10.1007/s12070-021-02640-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Accepted: 05/17/2021] [Indexed: 11/25/2022] Open
Abstract
Sinonasal inverting papilloma is a rare benign, locally aggressive tumour, arising from sinus and/or nasal fossa mucosa, with high recurrence rate, and risk of malignant transformation. This is a case of orbital invasive, lateral extending inverting papilloma approached via combined external and endoscopic surgery.
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Affiliation(s)
- Antonio Romano
- Maxillofacial Surgery Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University Federico II, Via Pansini 5, 80100 Naples, Italy
| | - Giovanni Audino
- Maxillofacial Surgery Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University Federico II, Via Pansini 5, 80100 Naples, Italy
| | - Vincenzo Abbate
- Maxillofacial Surgery Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University Federico II, Via Pansini 5, 80100 Naples, Italy
| | - Giovanni Dell’Aversana Orabona
- Maxillofacial Surgery Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University Federico II, Via Pansini 5, 80100 Naples, Italy
| | - Giovanni Salzano
- Maxillofacial Surgery Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University Federico II, Via Pansini 5, 80100 Naples, Italy
| | - Francesco Seidita
- Maxillofacial Surgery Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University Federico II, Via Pansini 5, 80100 Naples, Italy
| | - Lorenzo Sani
- Maxillofacial Surgery Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University Federico II, Via Pansini 5, 80100 Naples, Italy
| | - Giorgio Iaconetta
- Neurosurgery Unit, Department of Medicine, Surgery and Odontoiatrics, University of Salerno, Via Giovanni Paolo II 132, 84084 Fisciano, Salerno Italy
| | - Luigi Califano
- Maxillofacial Surgery Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University Federico II, Via Pansini 5, 80100 Naples, Italy
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Indications and Outcomes of the Osteoplastic Flap Procedure With or Without Obliteration. J Craniofac Surg 2020; 31:2243-2249. [PMID: 33136864 DOI: 10.1097/scs.0000000000006717] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVE To describe the osteoplastic approach and to perform a systematic review of the indications and outcomes of the osteoplastic flap procedure for frontal sinus surgeries with or without obliteration. DATA SOURCES PubMed, Medline, Google Scholar, and Cochrane databases. REVIEW METHODS All published studies in the English language on the osteoplastic flap with or without obliteration were identified from 1905 to 2018. All studies with <20 patients were excluded. The number of patients, technique, indications, follow-up period, symptom relief, revision rates, and complications were recorded and analyzed. RESULTS A systematic review yielded 25 series containing 1374 patients for analysis. Indications for surgery included chronic frontal sinusitis, mucoceles, fractures or traumas, osteomas, neoplasms, and cerebrospinal fluid leak. The mean follow-up period ranged from 12.8 to 144 months. The percentage of patients needing revisions for frontal sinus disease was 6.2%. There was a high rate of symptomatic improvement (85.0%) and a low rate of major complications (0.7%). However, minor complications occurred in 19.4% of patients. CONCLUSION The osteoplastic flap with or without obliteration has many indications. In an era where endoscopic technique provides excellent access to the frontal sinuses, external approaches remain a useful adjunct, and/or salvage technique. In experienced hands, the osteoplastic flap can yield excellent long-term clinical results, with low rates of complications. Regardless of the surgical approach, long-term follow-up is necessary due to the recurrent nature of frontal sinus disease.
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6
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Binz GHA, Soyka MB, Holzmann D, Meerwein CM. Need for long-term follow-up in sinonasal inverted papilloma: A Single-institution experience. Head Neck 2020; 43:630-638. [PMID: 33103314 DOI: 10.1002/hed.26523] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 10/14/2020] [Accepted: 10/14/2020] [Indexed: 12/11/2022] Open
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.
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Affiliation(s)
- Gregori H A Binz
- Department of Otorhinolaryngology - Head and Neck Surgery, University Hospital Zurich, Zürich, Switzerland.,University of Zurich, Zurich, Switzerland
| | - Michael B Soyka
- Department of Otorhinolaryngology - Head and Neck Surgery, University Hospital Zurich, Zürich, Switzerland.,University of Zurich, Zurich, Switzerland
| | - David Holzmann
- Department of Otorhinolaryngology - Head and Neck Surgery, University Hospital Zurich, Zürich, Switzerland.,University of Zurich, Zurich, Switzerland
| | - Christian M Meerwein
- Department of Otorhinolaryngology - Head and Neck Surgery, University Hospital Zurich, Zürich, Switzerland.,University of Zurich, Zurich, Switzerland
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7
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Nakayama T, Tsunemi Y, Kashiwagi T, Kuboki A, Yamakawa S, Konno W, Mori A, Iimura J, Tsukidate T, Tanaka Y, Haruna SI. Comparison of Current Staging Systems for Sinonasal Inverted Papilloma. Am J Rhinol Allergy 2020; 35:64-71. [DOI: 10.1177/1945892420933178] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Background A staging system is essential for determining the optimal surgical approach and predicting postoperative outcomes for inverted papilloma (IP). Although staging systems based on the extent to which the location is occupied by an IP have been widely used, an origin site-based classification of IP using unsupervised machine learning algorithms has recently been reported. Objective To determine the most appropriate of five staging systems for sinonasal IP by comparing recurrence rates for each stage according to each of those systems. Methods Eighty-seven patients with sinonasal IP were enrolled in the study. Their tumors were retrospectively categorized according to the Krouse, Oikawa, Cannady, and Han staging systems, which are based on the extent of IP, and the Meng system, which is based on the site of origin. The rates of recurrence for each stage of the five systems were compared. Results Seven of the 87 patients (8.0%) had recurrences during an average 45.5 months (12–138 months) of follow-up. There were significant differences in disease-free survival between the stages specified by Han and Meng (p = 0.027 and p < 0.001, respectively), but not between the stages specified by Krouse, Oikawa, and Cannady (p = 0.236, 0.062, and 0.130, respectively). Cox proportional hazard models revealed that Meng system (adjusted hazard ratio [aHR] 4.32, 95% confidence interval [CI] 1.10–17.04) and presence of dysplasia (aHR 7.42, 95% CI 1.15–47.85) were significantly associated with recurrence. Conclusion The staging systems proposed by Han and Meng were found to be accurate in terms of tumor recurrence. We recommend use of the Han staging system before surgery and the Meng system after intraoperative identification of the origin of the tumor.
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Affiliation(s)
- Tsuguhisa Nakayama
- Department of Otorhinolaryngology-Head and Neck Surgery, Dokkyo Medical University, Tochigi, Japan
- Department of Otorhinolaryngology, Jikei University School of Medicine, Tokyo, Japan
| | - Yasuhiro Tsunemi
- Department of Otorhinolaryngology-Head and Neck Surgery, Dokkyo Medical University, Tochigi, Japan
| | - Takashi Kashiwagi
- Department of Otorhinolaryngology-Head and Neck Surgery, Dokkyo Medical University, Tochigi, Japan
| | - Akihito Kuboki
- Department of Otorhinolaryngology-Head and Neck Surgery, Dokkyo Medical University, Tochigi, Japan
- Department of Otorhinolaryngology, Jikei University School of Medicine, Tokyo, Japan
| | - Shuchi Yamakawa
- Department of Otorhinolaryngology-Head and Neck Surgery, Dokkyo Medical University, Tochigi, Japan
| | - Wataru Konno
- Department of Otorhinolaryngology-Head and Neck Surgery, Dokkyo Medical University, Tochigi, Japan
| | - Aya Mori
- Department of Otorhinolaryngology-Head and Neck Surgery, Dokkyo Medical University, Tochigi, Japan
- Department of Otorhinolaryngology-Head and Neck Surgery, Dokkyo Medical University Saitama Medical Center, Saitama, Japan
| | - Jiro Iimura
- Department of Otorhinolaryngology-Head and Neck Surgery, Dokkyo Medical University, Tochigi, Japan
- Department of Otorhinolaryngology, Jikei University School of Medicine, Tokyo, Japan
| | - Toshiharu Tsukidate
- Department of Otorhinolaryngology-Head and Neck Surgery, Dokkyo Medical University, Tochigi, Japan
- Department of Otorhinolaryngology, Jikei University School of Medicine, Tokyo, Japan
| | - Yasuhiro Tanaka
- Department of Otorhinolaryngology-Head and Neck Surgery, Dokkyo Medical University Saitama Medical Center, Saitama, Japan
| | - Shin-ichi Haruna
- Department of Otorhinolaryngology-Head and Neck Surgery, Dokkyo Medical University, Tochigi, Japan
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Martinez-Monedero R, Danielian A, Angajala V, Dinalo JE, Kezirian EJ. Methodological Quality of Systematic Reviews and Meta-analyses Published in High-Impact Otolaryngology Journals. Otolaryngol Head Neck Surg 2020; 163:892-905. [PMID: 32450783 DOI: 10.1177/0194599820924621] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
OBJECTIVE To assess the methodological quality of intervention-focused systematic reviews (SRs) and meta-analyses (MAs) published in high-impact otolaryngology journals. DATA SOURCES Ovid Medline, Embase, and Cochrane Library. REVIEW METHODS A comprehensive search was performed for SR and MA citations from 2012 to 2017 in the 10 highest impact factor otolaryngology journals. Abstracts were screened to identify published manuscripts in which the authors indicated clearly that they were performing an SR or MA. Applying a modified typology of reviews, 4 reviewers characterized the review type as SR, MA, or another review type. A simplified version of the AMSTAR 2 (A MeaSurement Tool to Assess systematic Reviews 2) tool was used to assess the reporting and methodological quality of the SRs and MAs that were focused on interventions. RESULTS Search and abstract screening generated 499 manuscripts that identified themselves as performing an SR or MA. A substantial number (85/499, 17%) were review types other than SRs or MAs, including 34 (7%) that were literature reviews. In total, 236 SRs and MAs focused on interventions. Over 50% of these SRs and MAs had weaknesses in at least 3 of the 16 items in the AMSTAR 2, and over 40% had weaknesses in at least 2 of the 7 critical domains. Ninety-nine percent of SRs and MAs provided critically low confidence in the results of the reviews. CONCLUSION Intervention-focused SRs and MAs published in high-impact otolaryngology journals have important methodological limitations that diminish confidence in the results of these reviews.
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Affiliation(s)
- Rodrigo Martinez-Monedero
- USC Caruso Department of Otolaryngology-Head & Neck Surgery, Keck School of Medicine of USC, California, USA
| | - Arman Danielian
- Department of Head and Neck Surgery, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
| | - Varun Angajala
- Keck School of Medicine of USC, Los Angeles, California, USA
| | - Jennifer E Dinalo
- Health Sciences Libraries, Keck School of Medicine of USC, Los Angeles, California, USA
| | - Eric J Kezirian
- USC Caruso Department of Otolaryngology-Head & Neck Surgery, Keck School of Medicine of USC, California, USA
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Surgical Management of a Recurrent Orbit-Eroding Mucocele Associated With Frontal-Ethmoidal Sinus Inverted Papilloma. Ophthalmic Plast Reconstr Surg 2020; 35:e136-e138. [PMID: 31567913 DOI: 10.1097/iop.0000000000001465] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The development of orbit-eroding mucocele associated with inverted papilloma has been rarely reported., Here, the authors present a case and surgical management of a patient with orbit-eroding mucocele associated with inverted papilloma who declined craniotomy. A combined approach utilizing frontal endoscopic sinus surgery and external sub-brow anterior orbitotomy was used to explore, drain, and excise the mucocele and inverted papilloma. Gelatin sponges soaked in gentamicin were used to cover the exposed dura and to protect the orbital content from the frontal sinus cavity.A fronto-ethmoidal sinus inverted papilloma associated with recurrent orbit-eroding mucocele was excised by combined transnasal endoscopic and external sub-brow anterior orbitotomy approach using stereotactic navigation.
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10
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Pietrobon G, Karligkiotis A, Turri-Zanoni M, Fazio E, Battaglia P, Bignami M, Castelnuovo P. Surgical management of inverted papilloma involving the frontal sinus: a practical algorithm for treatment planning. ACTA ACUST UNITED AC 2019; 39:28-39. [PMID: 30936576 PMCID: PMC6444166 DOI: 10.14639/0392-100x-2313] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2018] [Accepted: 10/15/2018] [Indexed: 11/23/2022]
Abstract
Inverted papilloma of the frontal sinus is a challenging disease. Given its rarity, only small case series are present in the literature. The objectives of the present study are to review our experience in the surgical management of inverted papillomas involving the frontal sinus and to propose a practical algorithm for selecting the most appropriate approach. Data on patients affected by inverted papilloma involving the frontal sinus and surgically treated between 2002 and 2016 were collected. The type of involvement of frontal sinus and extent of surgery performed (endoscopic endonasal, external or combined approaches) were analysed. A brief review of consistent literature was also carried out. Forty-seven consecutive patients were treated using an exclusive endoscopic endonasal approach (EEA) in 18 cases, while a combined endonasal with external osteoplastic approach was required in 29 cases. Most patients (29/47, 62%) had been treated previously, mainly by an endoscopic approach. A single intraoperative complication occurred (1/47, 2%), i.e. cerebrospinal fluid (CSF) leak, that was successfully repaired intraoperatively without any consequences. Recurrences were observed in only 2/47 cases (4%) after a mean follow-up of 43 months (range, 12-137). The management of inverted papilloma involving the frontal sinus requires great expertise and the surgical technique should be tailored to the site of attachment of the tumour, its extension and the anatomical conformation of each frontal sinus. The encouraging results obtained in this case series support the use of this practical treatment algorithm.
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Affiliation(s)
- G Pietrobon
- Division of Otorhinolaryngology, Department of Biotechnology and Life Sciences, University of Insubria, ASST Sette Laghi, Ospedale di Circolo e Fondazione Macchi, Varese, Italy
| | - A Karligkiotis
- Division of Otorhinolaryngology, Department of Biotechnology and Life Sciences, University of Insubria, ASST Sette Laghi, Ospedale di Circolo e Fondazione Macchi, Varese, Italy.,Head and Neck Surgery & Forensic Dissection Research center (HNS&FDRc), Department of Biotechnology and Life Sciences, University of Insubria, Varese, Italy
| | - M Turri-Zanoni
- Division of Otorhinolaryngology, Department of Biotechnology and Life Sciences, University of Insubria, ASST Sette Laghi, Ospedale di Circolo e Fondazione Macchi, Varese, Italy.,Head and Neck Surgery & Forensic Dissection Research center (HNS&FDRc), Department of Biotechnology and Life Sciences, University of Insubria, Varese, Italy
| | - E Fazio
- Division of Otorhinolaryngology, Department of Biotechnology and Life Sciences, University of Insubria, ASST Sette Laghi, Ospedale di Circolo e Fondazione Macchi, Varese, Italy
| | - P Battaglia
- Division of Otorhinolaryngology, Department of Biotechnology and Life Sciences, University of Insubria, ASST Sette Laghi, Ospedale di Circolo e Fondazione Macchi, Varese, Italy.,Head and Neck Surgery & Forensic Dissection Research center (HNS&FDRc), Department of Biotechnology and Life Sciences, University of Insubria, Varese, Italy
| | - M Bignami
- Division of Otorhinolaryngology, Department of Biotechnology and Life Sciences, University of Insubria, ASST Sette Laghi, Ospedale di Circolo e Fondazione Macchi, Varese, Italy.,Head and Neck Surgery & Forensic Dissection Research center (HNS&FDRc), Department of Biotechnology and Life Sciences, University of Insubria, Varese, Italy
| | - P Castelnuovo
- Division of Otorhinolaryngology, Department of Biotechnology and Life Sciences, University of Insubria, ASST Sette Laghi, Ospedale di Circolo e Fondazione Macchi, Varese, Italy.,Head and Neck Surgery & Forensic Dissection Research center (HNS&FDRc), Department of Biotechnology and Life Sciences, University of Insubria, Varese, Italy
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11
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Sham CL, van Hasselt CA, Chow SMW, Lee DLY, Cho RHW, Woo JKS, Tong MCF. Frontal inverted papillomas: A 25-year study. Laryngoscope 2019; 130:1622-1628. [PMID: 31418865 PMCID: PMC7318241 DOI: 10.1002/lary.28245] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2019] [Revised: 07/17/2019] [Accepted: 07/31/2019] [Indexed: 12/19/2022]
Abstract
Objectives/Hypothesis This study analyzes the treatment outcomes of frontal inverted papillomas (FIPs) in an attempt to provide guidelines for surgery selection. Study Design Retrospective case series. Methods The treatment results of 29 FIPs classified into five categories were retrospectively analyzed. The five categories are F1, tumor prolapsed into frontal sinus, tumor origin outside frontal sinus; F2, tumor origin inside frontal sinus, medial to the plane of lamina papyracea; F3, tumor origin inside frontal sinus, lateral to the plane of lamina papyracea; F4, bilateral; and F5, extrasinonasal. Results Of the 11 F1 cases, 73% had Draf I and 27% had Draf IIA procedures. There was one (9%) frontal recurrence and one (9%) frontal stenosis. Of the 10 F2 cases, 10% had Draf I, 40% had Draf IIA, 40% had Draf IIB, and 10% had Draf III surgery with a trephination. One patient (10%) had a frontal recurrence. Of the five F3 cases, 40% had Draf IIA surgery, 20% had external frontoethmoidectomy, and 40% had external frontal sinusotomy. The recurrence rate was 60%, and frontal stenosis rate was 60%. The two F4 cases had external frontal sinusotomies and Draf III surgery with no frontal recurrence or stenosis. The patient with the F5 had a frontal recurrence after Draf IIA surgery and external frontoethmoidectomy. Conclusions Draf I or IIA surgery is adequate for most F1 tumors, and Draf II surgery is adequate for most F2 tumors. F3 and F4 tumors can be managed initially by Draf III surgery with external frontal sinusotomy added when required. F5 tumors probably require combined surgical approaches. Level of Evidence 4 Laryngoscope, 130:1622–1628, 2020
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Affiliation(s)
- Cheuk Lun Sham
- Department of Otorhinolaryngology-Head and Neck Surgery, Chinese University of Hong Kong, Hong Kong
| | - C Andrew van Hasselt
- Department of Otorhinolaryngology-Head and Neck Surgery, Chinese University of Hong Kong, Hong Kong
| | - Samuel M W Chow
- Department of Otorhinolaryngology-Head and Neck Surgery, Chinese University of Hong Kong, Hong Kong
| | - Dennis L Y Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, Chinese University of Hong Kong, Hong Kong
| | - Ryan H W Cho
- Department of Otorhinolaryngology-Head and Neck Surgery, Chinese University of Hong Kong, Hong Kong
| | - John K S Woo
- Department of Otorhinolaryngology-Head and Neck Surgery, Chinese University of Hong Kong, Hong Kong
| | - Michael C F Tong
- Department of Otorhinolaryngology-Head and Neck Surgery, Chinese University of Hong Kong, Hong Kong
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12
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Geltzeiler M, Mowery A, Detwiller KY, Mace JC, Smith TL. Frontal sinus "mega-trephination" in a tertiary rhinology practice. Int Forum Allergy Rhinol 2019; 9:1189-1195. [PMID: 31403757 DOI: 10.1002/alr.22405] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Revised: 06/12/2019] [Accepted: 07/16/2019] [Indexed: 11/07/2022]
Abstract
BACKGROUND Frontal sinus trephination is traditionally performed through a small cutaneous incision and osteotomy, allowing irrigation of the frontal sinus. Utilizing the trephination osteotomy for endoscopic visualization and surgical manipulation requires a larger opening. This "mega-trephination" is thought to carry an increased risk of cosmetic deformity given the increased bony removal at the anterior table. The purpose of our study was to clarify the risks of frontal sinus mega-trephination and examine how this technique is incorporated into a modern, tertiary care rhinology practice. METHODS Patients were identified through billing records and confirmed by retrospective chart review. All patients underwent frontal sinus mega-trephination, which is defined as an osteotomy large enough for insertion of a 4-mm endoscope and an operative instrument simultaneously. All patients had at least 2 years of follow-up. The primary outcome was complication rate, including cosmetic deformity. RESULTS Sixty-four patients underwent frontal sinus mega-trephination from 2006 to 2016. The most common surgical indications were chronic sinusitis (34%), mucocele (19%), osteoma (17%), acute sinusitis (11%), and inverting papilloma (9%). Ten patients (16%) underwent mega-trephination alone, whereas the others had mega-trephination with endoscopic sinus surgery. Twenty-one patients (33%) had minor complications. The most common complications were self-limited paresthesia (11%), infection (8%), and epistaxis (3%). No patient complained of permanent cosmetic deformity or required revision surgery for cosmesis. CONCLUSION Frontal sinus mega-trephination is a useful tool to augment the rhinologist's armamentarium in complex frontal sinus anatomy and pathology. This procedure is well tolerated, safe, and not associated with long-term cosmetic deformity.
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Affiliation(s)
- Mathew Geltzeiler
- Oregon Sinus Center, Division of Rhinology & Sinus/Skull Base Surgery, Department of Otolaryngology-Head & Neck Surgery, Oregon Health & Science University, Portland, OR
| | - Alia Mowery
- Oregon Sinus Center, Division of Rhinology & Sinus/Skull Base Surgery, Department of Otolaryngology-Head & Neck Surgery, Oregon Health & Science University, Portland, OR
| | - Kara Y Detwiller
- Oregon Sinus Center, Division of Rhinology & Sinus/Skull Base Surgery, Department of Otolaryngology-Head & Neck Surgery, Oregon Health & Science University, Portland, OR
| | - Jess C Mace
- Oregon Sinus Center, Division of Rhinology & Sinus/Skull Base Surgery, Department of Otolaryngology-Head & Neck Surgery, Oregon Health & Science University, Portland, OR
| | - Timothy L Smith
- Oregon Sinus Center, Division of Rhinology & Sinus/Skull Base Surgery, Department of Otolaryngology-Head & Neck Surgery, Oregon Health & Science University, Portland, OR
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13
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Tong CCL, Patel NN, Maina IW, Triantafillou V, Yan CH, Kuan EC, Kohanski MA, Papagiannopoulos P, Workman AD, Cohen NA, Kennedy DW, Adappa ND, Palmer JN. Inverted papilloma with multifocal attachment is associated with increased recurrence. Int Forum Allergy Rhinol 2019; 9:865-869. [PMID: 31125506 DOI: 10.1002/alr.22342] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Revised: 02/13/2019] [Accepted: 03/13/2019] [Indexed: 11/08/2022]
Abstract
BACKGROUND Inverted papilloma (IP) is a benign sinonasal tumor with a well-known propensity to recur, especially at its bony attachment site. Anecdotal evidence suggests lower rate of recurrence in primary resection. We also aimed to evaluate the effect of multifocal vs single focus of attachment in disease control. METHODS This work is a retrospective review of 535 IP resections performed during the period from 2006 to 2016 at a tertiary-care center. Demographic data, tumor location and attachment sites, and follow-up duration data were obtained. RESULTS Two hundred ten patients were eligible for analysis. The mean age was 57 years, with an average postoperative surveillance of 36.4 months. Patients who had a previous procedure at an outside institution have a recurrence rate of 22.3%, compared with 12.4% for patients who had primary surgery at our institution. The most common site of attachment was maxillary sinus (47.6%), followed by ethmoid sinus (39%). Individual tumor review showed 50% of the patients to have multifocal attachment disease, of which there is a higher prevalence in secondary cases when compared with primary cases (53.7% vs 44.9%). Multiple tumor attachment sites had a significant effect on recurrence (odds ratio, 3.5; 95% confidence interval, 1.6-7.6; p = 0.002). CONCLUSION Primary resection and single-focus attachment of inverted papilloma are associated with lower recurrence rates at 3-year follow-up.
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Affiliation(s)
- Charles C L Tong
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania Health System, Philadelphia, PA
| | - Neil N Patel
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania Health System, Philadelphia, PA
| | - Ivy W Maina
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania Health System, Philadelphia, PA
| | - Vasiliki Triantafillou
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania Health System, Philadelphia, PA
| | - Carol H Yan
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania Health System, Philadelphia, PA
| | - Edward C Kuan
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania Health System, Philadelphia, PA
| | - Michael A Kohanski
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania Health System, Philadelphia, PA
| | - Peter Papagiannopoulos
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania Health System, Philadelphia, PA
| | - Alan D Workman
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania Health System, Philadelphia, PA
| | - Noam A Cohen
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania Health System, Philadelphia, PA
| | - David W Kennedy
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania Health System, Philadelphia, PA
| | - Nithin D Adappa
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania Health System, Philadelphia, PA
| | - James N Palmer
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania Health System, Philadelphia, PA
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14
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Lee JJ, Roland LT, Licata JJ, Orlowski HLP, Jiramongkolchai P, Piccirillo JF, Kallogjeri D, Klatt-Cromwell CN, Chernock RD, Schneider JS. Morphologic, intraoperative, and histologic risk factors for sinonasal inverted papilloma recurrence. Laryngoscope 2019; 130:590-596. [PMID: 31112326 DOI: 10.1002/lary.28078] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Revised: 04/17/2019] [Accepted: 05/01/2019] [Indexed: 12/20/2022]
Abstract
OBJECTIVE Sinonasal inverted papillomas (IP) are benign neoplasms with a propensity for local recurrence. Many risk factors are reported, with little consistency between studies. This study aimed to comprehensively assess for demographic, imaging, histopathologic, and intraoperative risk factors for recurrence. METHODS We performed a single-center retrospective cohort study of patients with pathologically diagnosed IP without malignancy who underwent surgical resection between 1997 and 2018. Eligible patients were identified through a database maintained by the Department of Pathology. Logistic regression identified variables associated with recurrence, and conjunctive consolidation was performed to create a predictive model. RESULTS Of 76 subjects, 37% (n = 28) had recurrence. Median follow-up and time to recurrence were 2.9 (range 0.5-21.1) and 1.7 (range 0.2-13.0) years, respectively. Confirmed negative margins on histology were protective (odds ratio [OR] 0.25, 95% confidence interval [CI] 0.08-0.85). Frontal sinus involvement (adjusted odds ratio [aOR] 5.83, 95% CI 1.20-28.37), incomplete resection (aOR 9.67, 95% CI 2.24-41.72), and presence of dysplasia (aOR 4.38, 95% CI 1.01-19.10) were significantly associated with recurrence on multivariable analysis. A three-level composite recurrence risk staging system was created by consolidating the above three variables. The recurrence risks of composite stage I, II, and III disease were 20%, 38%, and 100%, respectively. No demographic, imaging, staging, or surgical approach variables were associated with recurrence. CONCLUSION Frontal sinus involvement, incomplete resection, and dysplasia were significant risk factors for IP recurrence, whereas confirmed negative margins were protective. Creation of a composite staging system using the above variables may allow for risk stratification and a patient-specific approach to postoperative IP management. LEVEL OF EVIDENCE 3 Laryngoscope, 130:590-596, 2020.
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Affiliation(s)
- Jake J Lee
- Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine, St. Louis, Missouri
| | - Lauren T Roland
- Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine, St. Louis, Missouri.,Department of Otolaryngology-Head and Neck Surgery, Emory Medicine, Atlanta, Georgia, U.S.A
| | - Jordan J Licata
- Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine, St. Louis, Missouri
| | - Hilary L P Orlowski
- Department of Radiology, Washington University School of Medicine, St. Louis, Missouri
| | - Pawina Jiramongkolchai
- Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine, St. Louis, Missouri
| | - Jay F Piccirillo
- Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine, St. Louis, Missouri
| | - Dorina Kallogjeri
- Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine, St. Louis, Missouri
| | - Cristine N Klatt-Cromwell
- Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine, St. Louis, Missouri
| | - Rebecca D Chernock
- Department of Pathology, Washington University School of Medicine, St. Louis, Missouri
| | - John S Schneider
- Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine, St. Louis, Missouri
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15
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Coutinho G, Marques J, Leal M, Spratley J, Fernandes MS, Santos M. Surgical outcomes of sinonasal inverted papilloma: a 17 year review. Braz J Otorhinolaryngol 2019; 86:315-320. [PMID: 30852156 PMCID: PMC9422424 DOI: 10.1016/j.bjorl.2018.12.011] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Revised: 12/02/2018] [Accepted: 12/11/2018] [Indexed: 12/04/2022] Open
Abstract
Introduction Inverted papillomas represent one of the most common benign neoplasic lesions located in the sinonasal tract. Owing to the local erosive behavior, tendency to recur and the potential for malignant transformation, surgical management of inverted papillomas is often challenging. Objective This study aimed to analyze the surgical outcomes of patients with inverted papillomas, according to the Krouse staging and the different surgical approaches. Methods Retrospective study of patients diagnosed with sinonasal inverted papillomas who underwent surgical treatment between 2000 and 2016 at a tertiary referral hospital. Cases with follow-up less than 12 months were excluded. The rate and the time of recurrence were the main outcomes. Values of p < 0.05 were considered statistically significant. Results Thirty-six cases with mean age of 60 years, predominantly male (72%), were included. The follow-up period ranged from 1 to 16 years, with an average of 4.5 years. Krouse T1 Stage corresponded to 11.1%; T2 occurred in 50% of cases; while T3 and T4 Stages accounted for 30.6% and 8.3% of patients, respectively. Most cases were approached by an endoscopic technique alone (83.3%), with a recurrence rate of 13.3%. Patients treated via a combined or open approach revealed a recurrence of 16.7%. No differences in the recurrence rate were reported when comparing endoscopic surgery with the open or combined techniques. Krouse Stage T3 had a significant association with inverted papillomas recurrence (p = 0.023). All inverted papilloma relapses occurred up to 2 years post-operatively. One case of malignant transformation was recorded (2.7%). Conclusion Endoscopic surgery did not increase the recurrence rates and can be a safe and efficient alternative to open or combined techniques. The recurrence of inverted papillomas seem to be related to the persistence of the disease and tend to occur early after primary surgery. Krouse T3 Stages may be associated with a higher recurrence of inverted papillomas.
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Affiliation(s)
- Gil Coutinho
- Centro Hospitalar São João, Departamento de Otorrinolaringologia, Porto, Portugal; Faculdade de Medicina da Universidade do Porto, Unidade de Otorrinolaringologia, Porto, Portugal.
| | - Joana Marques
- Centro Hospitalar São João, Departamento de Otorrinolaringologia, Porto, Portugal; Faculdade de Medicina da Universidade do Porto, Unidade de Otorrinolaringologia, Porto, Portugal
| | - Manuel Leal
- Centro Hospitalar São João, Departamento de Otorrinolaringologia, Porto, Portugal; Faculdade de Medicina da Universidade do Porto, Unidade de Otorrinolaringologia, Porto, Portugal
| | - Jorge Spratley
- Centro Hospitalar São João, Departamento de Otorrinolaringologia, Porto, Portugal; Faculdade de Medicina da Universidade do Porto, Unidade de Otorrinolaringologia, Porto, Portugal; Centro de Investigação em Tecnologia e Serviços de Saúde (CINTESIS), Porto, Portugal
| | - Margarida Sá Fernandes
- Centro Hospitalar São João, Departamento de Patologia, Porto, Portugal; Universidade do Porto, Faculdade de Medicina, Departamento de Patologia, Porto, Portugal
| | - Margarida Santos
- Centro Hospitalar São João, Departamento de Otorrinolaringologia, Porto, Portugal
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16
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Peng R, Thamboo A, Choby G, Ma Y, Zhou B, Hwang PH. Outcomes of sinonasal inverted papilloma resection by surgical approach: an updated systematic review and meta‐analysis. Int Forum Allergy Rhinol 2019; 9:573-581. [DOI: 10.1002/alr.22305] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2018] [Revised: 12/20/2018] [Accepted: 01/08/2019] [Indexed: 12/18/2022]
Affiliation(s)
- Rui Peng
- Department of Otolaryngology–Head and Neck SurgeryStanford University School of Medicine Stanford CA
- Department of Otolaryngology–Head and Neck Surgery, Beijing Tongren HospitalCapital Medical University Beijing China
| | - Andrew Thamboo
- Department of Otolaryngology–Head and Neck SurgeryStanford University School of Medicine Stanford CA
- Department of Surgery, Division of OtolaryngologyUniversity of British Columbia Vancouver BC Canada
| | - Garret Choby
- Department of Otolaryngology–Head and Neck SurgeryStanford University School of Medicine Stanford CA
- Department of Otorhinolaryngology–Head and Neck SurgeryMayo Clinic Rochester MN
| | - Yifei Ma
- Department of Otolaryngology–Head and Neck SurgeryStanford University School of Medicine Stanford CA
| | - Bing Zhou
- Department of Otolaryngology–Head and Neck Surgery, Beijing Tongren HospitalCapital Medical University Beijing China
| | - Peter H. Hwang
- Department of Otolaryngology–Head and Neck SurgeryStanford University School of Medicine Stanford CA
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17
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Meng Y, Fang G, Wang X, Song X, Wang K, Lou H, She W, Qin L, Lv M, Zhang T, Yuan T, Tao Y, Meng X, Zhang L, Wang C. Origin site-based staging system of sinonasal inverted papilloma for application to endoscopic sinus surgery. Head Neck 2018; 41:440-447. [PMID: 30554455 PMCID: PMC6590184 DOI: 10.1002/hed.25435] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Revised: 07/20/2018] [Accepted: 09/12/2018] [Indexed: 12/30/2022] Open
Abstract
Background We aimed to assess the recurrence risk of sinonasal inverted papillomas (SNIPs), based on a staging system developed according to the originating site of SNIP. Methods A total of 200 patients with SNIP were enrolled, and a staging system was developed based on the originating sites and corresponding recurrence rates of tumor in the patients. In the verification phase, 675 patients with SNIPs were enrolled as above, and the originating sites of the SNIPs were confirmed by an endoscopic sinus surgery. Cluster analysis was performed to determine the stage for each SNIP. Results Overall, 608 patients completed the study. SNIP recurrence rates for stages 1‐4 were 0 (n = 43), 4.0% (n = 420), 13.4% (n = 134), 36.4% (n = 11), respectively (total = 6.4%). Conclusions The origin site‐based classification of SNIP may aid surgeons in selecting appropriate endoscopic surgical approaches to minimize the risk of recurrence.
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Affiliation(s)
- Yifan Meng
- Department of Otolaryngology, Head and Neck Surgery, Beijing TongRen Hospital, Capital Medical University, Beijing, China
| | - Gaoli Fang
- Department of Otolaryngology, Head and Neck Surgery, Beijing Ditan Hospital, Capital Medical University, Beijing, China
| | - Xiangdong Wang
- Department of Otolaryngology, Head and Neck Surgery, Beijing TongRen Hospital, Capital Medical University, Beijing, China
| | - Xiaohong Song
- Department of Otolaryngology, Head and Neck Surgery, Beijing TongRen Hospital, Capital Medical University, Beijing, China
| | - Kuiji Wang
- Department of Otolaryngology, Head and Neck Surgery, Beijing TongRen Hospital, Capital Medical University, Beijing, China
| | - Hongfei Lou
- Department of Otolaryngology, Head and Neck Surgery, Beijing TongRen Hospital, Capital Medical University, Beijing, China
| | - Wenyu She
- Department of Allergy, Beijing TongRen Hospital, Capital Medical University, Beijing, China
| | - Long Qin
- Department of Otolaryngology, Head and Neck Surgery, The Second Affiliated Hospital of Baotou Capital Medical University, Inner Mongolia, China
| | - Mei Lv
- Department of Otolaryngology, Head and Neck Surgery, The First Affiliated Hospital of Dalian Medical University, Liaoning, China
| | - Tao Zhang
- Department of Otolaryngology, Head and Neck Surgery, The First Affiliated Hospital of JiNan University, Guangdong, China
| | - Tiejun Yuan
- Department of Otolaryngology, Head and Neck Surgery, Weifang People's Hospital, Shandong, China
| | - Yanli Tao
- Department of Otolaryngology, Head and Neck Surgery, Weifang People's Hospital, Shandong, China
| | - Xun Meng
- Department of Otolaryngology, Head and Neck Surgery, The First Affiliated Hospital of JiNan University, Guangdong, China
| | - Luo Zhang
- Department of Otolaryngology, Head and Neck Surgery, Beijing TongRen Hospital, Capital Medical University, Beijing, China.,Department of Allergy, Beijing TongRen Hospital, Capital Medical University, Beijing, China.,Key Laboratory of Otolaryngology, Head and Neck Surgery, Ministry of Education, Beijing Institute of Otolaryngology, Beijing, China
| | - Chengshuo Wang
- Department of Otolaryngology, Head and Neck Surgery, Beijing TongRen Hospital, Capital Medical University, Beijing, China
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18
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Miglani A, Hoxworth JM, Zarka MA, Lal D. Use of intraoperative negative margins reduces inverted papilloma recurrence. Am J Rhinol Allergy 2018; 32:57-60. [PMID: 29336292 DOI: 10.2500/ajra.2018.32.4504] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND Recurrence of inverted papilloma (IP) is a problem in 12-17% of tumors. Controversy exists regarding benefits of intraoperative frozen section histopathology (IFSH) for IP resection; however, to our knowledge, no study has specifically investigated this. IFSH for IP resection is the standard of care in our practice. We, therefore, reviewed our outcomes of using IFSH for IP resection. A secondary goal was to assess the reliability of IFSH. METHODS Patients with IP who underwent surgical resection (2010-2016) with minimum 9-month follow-up were included. RESULTS Twenty-two adults with IP met inclusion criteria. All underwent surgery via endoscopic techniques, supplemented by external ports in five patients. At the time of presentation, 36% IPs were recurrent tumors; 68% were graded as Krouse stage 3. Resection was conducted until "clear" (negative) mucosal margins were achieved on IFSH. In 6 (27%), a "positive" IFSH result dictated additional resection to clear margins. Final negative margins were achieved in all the patients. Both positive and negative predictive values for IFSH were 100% (concordance with final pathology results). Surveillance was performed every 1-6 months with nasal endoscopy by using imaging when necessary. No recurrences were noted (0%) at mean follow-up of 40 months (range, 10-73 months). CONCLUSIONS Positive IFSH results led to increased resection in 27% of the patients, with a 0% recurrence rate in this cohort. The reliability of IFSH for IP is very high. No recurrence of IP was noted in any patient at a mean follow-up of 3.3 years. IFSH may help reduce recurrence rates of IP, but additional studies with longer follow-up are warranted.
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Affiliation(s)
- Amar Miglani
- From the Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Phoenix, Arizona
| | | | - Matthew A Zarka
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Phoenix, Arizona
| | - Devyani Lal
- From the Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Phoenix, Arizona
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19
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Makary CA, Limjuco A, Nguyen J, Ramadan HH. Combined Lid Crease and Endoscopic Approach to Lateral Frontal Sinus Disease With Orbital Extension. Ann Otol Rhinol Laryngol 2018; 127:637-642. [PMID: 29972305 DOI: 10.1177/0003489418784967] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Functional endoscopic sinus surgery for frontal sinus disease has obviated the need for external approaches. Special circumstances such as acute infection with orbital involvement or significant lateral sinus disease frequently require adjunct access. We describe the clinical outcomes of a combined upper eyelid crease and endoscopic approach for lateral frontal sinus disease with orbital extension. METHODS A retrospective case series of 7 patients who underwent a combined lid crease approach for frontal sinus disease with orbital extension between April 2012 and October 2016 was performed. All patients had the presence of lateral frontal sinus disease as well as orbital extension as seen on a preoperative computed tomography (CT) scan. Patient demographics, indications for surgery, and perioperative findings were examined. RESULTS Six of the 7 patients were male. Mean age was 61 years, and the indication for surgery was primarily drainage of mucopyocele and inverting papilloma (IP) in 1 patient. The frontal sinus and orbit were successfully accessed, and the respective pathology was addressed in both locations. No intraoperative or postoperative complications were encountered. There was no postoperative or cosmetic complications. CONCLUSION The combined lid crease and endoscopic approach is a safe and effective technique for accessing the lateral frontal sinus and orbit.
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Affiliation(s)
- Chadi A Makary
- 1 WVU medicine Ear, Nose and Throat, West Virginia University, Martinsburg, West Virginia, USA
| | - Alex Limjuco
- 2 Department of Otolaryngology, West Virginia University, Morgantown, West Virginia, USA
| | - John Nguyen
- 3 Department of Oculoplastic surgery, West Virginia University, Morgantown, West Virginia, USA
| | - Hassan H Ramadan
- 2 Department of Otolaryngology, West Virginia University, Morgantown, West Virginia, USA
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20
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Sinonasal papilloma: what influences the decision to request a magnetic resonance imaging scan? The Journal of Laryngology & Otology 2018; 132:584-590. [PMID: 29909780 DOI: 10.1017/s0022215118000804] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Computed tomography is the standard pre-operative imaging modality for sinonasal papilloma. The complementary use of magnetic resonance imaging as an additional investigation is debated. This study aimed to establish whether magnetic resonance imaging can accurately detect tumour extent and is a useful adjunct to computed tomography. METHODS A retrospective review was conducted on 19 patients with sinonasal papilloma. The interpretation of computed tomography and magnetic resonance imaging scans, by three clinicians, was conducted by comparing prediction of tumour extent. The perceived necessity of magnetic resonance imaging was compared between clinicians. RESULTS The addition of magnetic resonance imaging improved accuracy of pre-operative interpretation; specifically, this finding was significant in cases with frontal sinus involvement. Surgeons were more likely than a radiologist to request magnetic resonance imaging, particularly when computed tomography indicated frontal sinus disease. CONCLUSION Pre-operative combined magnetic resonance imaging and computed tomography helped predict disease in the frontal sinus better than computed tomography alone. A close working relationship between the ENT and radiology departments is important for accurate tumour localisation.
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21
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Albathi M, Ramanathan M, Lane AP, Boahene KDO. Combined endonasal and eyelid approach for management of extensive frontal sinus inverting papilloma. Laryngoscope 2017; 128:3-9. [PMID: 28407252 DOI: 10.1002/lary.26552] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2016] [Revised: 01/09/2017] [Accepted: 01/31/2017] [Indexed: 11/10/2022]
Abstract
OBJECTIVES Sinonasal inverting papilloma (IP) is a benign but locally aggressive mucosal neoplasm with a high recurrence rate. Extension into the frontal sinus presents surgical challenges for endonasal resection. This study presents an orbitofrontal approach for managing extensive IP. STUDY DESIGN Case series. METHODS Four patients seen between 2012 and 2016 with biopsy-proven IP with lateral frontal sinus extension underwent a combined endonasal and transpalpebral approach for tumor resection. Patient demographic data, preoperative characteristics, imaging, and follow-up data were compiled through retrospective chart review. Patients were selected for this approach when the tumor extended to the posterior frontal sinus wall, lateral frontal sinus recess, and orbit. Tumors were first approached endonasally until the frontal recess was reached. A Draf IIB or Draf III procedure was then performed to gain better exposure. Orbitofrontal exposure was achieved through an upper eyelid incision. Miniorbitofrontal craniotomy window was designed based on tumor location. Resection of the frontal and orbital extension was enhanced by endoscopic-assisted dissection through the orbitofrontal window. RESULTS The transpalpebral approach provided access to all walls of the ipsilateral frontal sinus, the intersinus septum, and the medial aspect of the contralateral sinus. Complete tumor resection was achieved in all patients. There were no orbital complications, no visible eyelid asymmetry or scarring, and all patients had preserved forehead sensation. There were no recurrences on follow-up. CONCLUSION Combining a transpalpebral orbitofrontal craniotomy with the endonasal approach allows complete resection of invasive IP with extension into the frontal sinus. This is achieved with great cosmetic results. LEVEL OF EVIDENCE 4. Laryngoscope, 128:3-9, 2018.
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Affiliation(s)
- Monirah Albathi
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, U.S.A
| | - Murugappan Ramanathan
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, U.S.A
| | - Andrew P Lane
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, U.S.A
| | - Kofi D O Boahene
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, U.S.A
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Abstract
The most common primary tumors of the frontal sinus are osteomas and inverted papillomas, although a variety of other tumors involving this space have been reported. With the advent of new surgical techniques and instrumentation, an endoscopic approach to this region has become feasible. The preoperative assessment and decision making must take into account the complexity of frontal sinus anatomy, tumor type, tumor location, and associated attachments. These procedures allow adequate visualization, tumor removal, and postoperative monitoring, and preserve fairly normal sinus function. Open techniques may also be required and should be in the surgeon's armamentarium.
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Affiliation(s)
- Anne Morgan Selleck
- Department of Otolaryngology-Head and Neck Surgery, University of North Carolina at Chapel Hill, 170 Manning Drive, CB #7070, Physician's Office Building, Room G-190, Chapel Hill, NC 27599-7070, USA
| | - Dipan Desai
- Department of Otolaryngology-Head and Neck Surgery, University of North Carolina at Chapel Hill, 170 Manning Drive, CB #7070, Physician's Office Building, Room G-190, Chapel Hill, NC 27599-7070, USA
| | - Brian D Thorp
- Department of Otolaryngology-Head and Neck Surgery, University of North Carolina at Chapel Hill, 170 Manning Drive, CB #7070, Physician's Office Building, Room G-190, Chapel Hill, NC 27599-7070, USA
| | - Charles S Ebert
- Department of Otolaryngology-Head and Neck Surgery, University of North Carolina at Chapel Hill, 170 Manning Drive, CB #7070, Physician's Office Building, Room G-190, Chapel Hill, NC 27599-7070, USA
| | - Adam M Zanation
- Department of Otolaryngology-Head and Neck Surgery, University of North Carolina at Chapel Hill, 170 Manning Drive, CB #7070, Physician's Office Building, Room G-190, Chapel Hill, NC 27599-7070, USA; Department of Neurosurgery, University of North Carolina at Chapel Hill, 170 Manning Drive, CB #7070, Physician's Office Building, Room G-190, Chapel Hill, NC 27599-7070, USA.
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Eloy JA, Marchiano E, Vázquez A. Extended Endoscopic and Open Sinus Surgery for Refractory Chronic Rhinosinusitis. Otolaryngol Clin North Am 2017; 50:165-182. [PMID: 27888912 DOI: 10.1016/j.otc.2016.08.013] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
This review discusses extended endoscopic and open sinus surgery for refractory chronic rhinosinusitis. Extended maxillary sinus surgery including endoscopic maxillary mega-antrostomy, endoscopic modified medial maxillectomy, and inferior meatal antrostomy are described. Total/complete ethmoidectomy with mucosal stripping (nasalization) is discussed. Extended endoscopic sphenoid sinus procedures as well as their indications and potential risks are reviewed. Extended endoscopic frontal sinus procedures, such the modified Lothrop procedure, are described. Extended open sinus surgical procedures, such as the Caldwell-Luc approach, frontal sinus trephine procedure, external frontoethmoidectomy, frontal sinus osteoplastic flap with or without obliteration, and cranialization, are discussed.
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Affiliation(s)
- Jean Anderson Eloy
- Department of Otolaryngology - Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, NJ, USA; Center for Skull Base and Pituitary Surgery, Neurological Institute of New Jersey, Rutgers New Jersey Medical School, Newark, NJ, USA; Department of Neurological Surgery, Rutgers New Jersey Medical School, Newark, NJ, USA; Department of Ophthalmology and Visual Science, Rutgers New Jersey Medical School, 90 Bergen Street, Suite 8100, Newark, NJ 07103, USA.
| | - Emily Marchiano
- Department of Otolaryngology - Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, NJ, USA
| | - Alejandro Vázquez
- Department of Otolaryngology - Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, NJ, USA
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Akkari M, Lassave J, Mura T, Gascou G, Pierre G, Cartier C, Garrel R, Crampette L. Atypical presentations of sinonasal inverted papilloma: Surgical management and influence on the recurrence rate. Am J Rhinol Allergy 2016; 30:149-54. [PMID: 26980397 DOI: 10.2500/ajra.2016.30.4288] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Sinonasal inverted papilloma (SNIP), classically, is a unilateral benign tumor of the nasal lateral wall. Numerous variations have been observed, depending on location, bilateral presentation, or association with nasal polyposis. OBJECTIVE The aim of this work was to describe atypical presentations of SNIPs with their management specificities and to assess their influence on the recurrence rate in a large case series. METHODS A retrospective single center study of 110 patients treated for SNIP. Atypical inverted papillomas were identified according to the following criteria: (1) unusual location (frontal, posterior, anterior), (2) bilateral involvement, and (3) association with nasal polyposis. Surgical management was detailed, and the influence of each atypical group on recurrence was assessed by using Kaplan-Meier survival curves and the log-rank test. RESULTS Distribution of atypical presentations was as follows: frontal sinus localization (10.9%); posterior localization, including sphenoid sinus (9%); nasal anterior localization (3.6%); bilateral involvement (3.6%); and nasal polyposis association (10%). The surgical approach was endoscopic (74.5%), external (5.5%), or combined endoscopic and external (20%). Except for nasal anterior localization, all the groups were associated with a higher recurrence rate, without reaching statistical significance. CONCLUSION Recurrence rates for these atypical presentations arise from their specific surgical challenges. The choice of the surgical technique is guided by tumor location and extension, and by the surgeon's experience; the main objective is a complete resection. The endoscopic endonasal approach is the most frequent procedure.
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Affiliation(s)
- Mohamed Akkari
- Department of Ear, Nose and Throat and Head and Neck Surgery, University Hospital Gui de Chauliac, University of Montpellier, Montpellier, France
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25
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Karligkiotis A, Pistochini A, Turri-Zanoni M, Terranova P, Volpi L, Battaglia P, Bignami M, Castelnuovo P. Endoscopic endonasal orbital transposition to expand the frontal sinus approaches. Am J Rhinol Allergy 2016; 29:449-56. [PMID: 26637586 DOI: 10.2500/ajra.2015.29.4230] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND The management of frontal sinus disease still remains a challenging issue for rhinologists. Although endoscopic frontal sinus surgery has significantly advanced over the past years, there are some conditions in which the external approaches are still necessary. Recently, the increasing experience in endoscopic sinus surgery together with important technologic advancements have allowed expansion of the indications for selected lesions localized more and more lateral into the frontal sinus. OBJECTIVE The aim of this study was to describe the endoscopic endonasal approach to the far lateral portion of the frontal sinus and to evaluate the outcomes of this technique. METHODS A retrospective evaluation was carried out with patients at a single institution, who, from 2004 to 2012, underwent an exclusive endoscopic transnasal approach to the far lateral portion of the frontal sinus at a single institution. The surgical technique included the Draf IIb procedure, a modified Lothrop procedure (Draf III), and endoscopic lateralization of the orbit, differently associated according to the needs of each case. RESULTS Twenty-four patients were eligible for the present study. The lesions included were mucoceles in 9 cases, fibro-osseous lesions in 10 cases, and inverted papillomas in 5 cases. The overall follow-up ranged from 12 to 120 months (mean, 40.6 months). At the time of the last follow-up, no recurrence of disease was observed in the patients treated; in one case of osteoma, a small and stable in size (1 mm) persistent lesion was observed in an asymptomatic patient. One scheduled and one accidental cerebrospinal fluid leak with immediate skull base reconstruction occurred. No intraoperative or postoperative early or late orbital complication was observed in any case. CONCLUSION The endoscopic endonasal orbital transposition seems to facilitate the endoscopic management of selected far-lateral frontal sinus lesions. However, it is a demanding procedure that requires experience and skill to avoid intraoperative skull base and orbital complications.
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Affiliation(s)
- Apostolos Karligkiotis
- Division of Otorhinolaryngology, Department of Biotechnology and Life Sciences, University of Insubria, Varese, Italy
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26
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Abstract
This review covers potential complications of frontal sinus surgical management and strategies for prevention of these complications. Accordingly, recent advances in frontal sinus surgical techniques are described, and the management of complications stemming both from these and traditional techniques are detailed.
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Abstract
The frontal sinus is the most complex of all paranasal sinuses. Given its proximity to the cranial vault and orbit, frontal sinus pathology can progress to involve these structures and lead to significant morbidity, or even mortality. Surgical management of the frontal sinus is technically challenging. Various open and endoscopic surgical techniques are available to the otolaryngologist. This article presents an overview of the major disease entities that affect the frontal sinus, with a special emphasis on treatment principles and surgical management.
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Rivera T, Rodríguez M, Pulido N, García-Alcántara F, Sanz L. Current Indications for the Osteoplastic Flap. ACTA ACUST UNITED AC 2016. [DOI: 10.1016/j.otoeng.2015.01.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Healy DY, Chhabra N, Metson R, Holbrook EH, Gray ST. Surgical risk factors for recurrence of inverted papilloma. Laryngoscope 2015; 126:796-801. [DOI: 10.1002/lary.25663] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/19/2015] [Indexed: 11/11/2022]
Affiliation(s)
- David Y. Healy
- Department of Otolaryngology; Naval Medical Center Portsmouth; Portsmouth Virginia
| | - Nipun Chhabra
- Department of Surgery; University of Illinois College of Medicine, Saint Anthony Medical Center; Rockford Illinois
| | - Ralph Metson
- Department of Otolaryngology; Massachusetts Eye and Ear Infirmary; Boston Massachusetts
- Department of Otology and Laryngology; Harvard Medical School; Boston Massachusetts U.S.A
| | - Eric H. Holbrook
- Department of Otolaryngology; Massachusetts Eye and Ear Infirmary; Boston Massachusetts
- Department of Otology and Laryngology; Harvard Medical School; Boston Massachusetts U.S.A
| | - Stacey T. Gray
- Department of Otolaryngology; Massachusetts Eye and Ear Infirmary; Boston Massachusetts
- Department of Otology and Laryngology; Harvard Medical School; Boston Massachusetts U.S.A
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30
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Gu ZW, Wang YX, Cao ZW. Inverted papilloma originating from the left ethmoid sinus invading the nasal cavity bilaterally via the frontal sinus septum. Braz J Otorhinolaryngol 2015; 81:684-6. [PMID: 26480905 PMCID: PMC9442760 DOI: 10.1016/j.bjorl.2015.03.017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2014] [Revised: 03/23/2015] [Accepted: 03/24/2015] [Indexed: 11/28/2022] Open
Affiliation(s)
- Zhao Wei Gu
- Department of Otorhinolaryngology, Shengjing Hospital of China Medical University, Liaoning Province, China
| | - Yun Xiu Wang
- Department of Otorhinolaryngology, Shengjing Hospital of China Medical University, Liaoning Province, China
| | - Zhi Wei Cao
- Department of Otorhinolaryngology, Shengjing Hospital of China Medical University, Liaoning Province, China.
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Adriaensen GFJPM, Lim KH, Georgalas C, Reinartz SM, Fokkens WJ. Challenges in the Management of Inverted Papilloma: A Review of 72 Revision Cases. Laryngoscope 2015; 126:322-8. [PMID: 26344930 DOI: 10.1002/lary.25522] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2015] [Revised: 06/24/2015] [Accepted: 06/26/2015] [Indexed: 11/10/2022]
Abstract
OBJECTIVES/HYPOTHESIS We report on the treatment outcome of endoscopically managed sinonasal inverted papilloma, focusing on revision cases. Our aim was to identify the properties of revision cases that affect treatment outcome by comparing them to primary cases in a single center. We propose using 5-fluorouracil (5-FU) in the postoperative management of inverted papilloma. STUDY DESIGN A retrospective single-center case series. This study met the criteria for approval by the local medical ethics committee. METHODS We performed a retrospective chart review identifying patients operated on between January 2003 and September 2013. Data were collected about patient demographics, symptoms, tumor attachment site, imaging, intraoperative and pathological findings, surgical approaches, postoperative treatment, follow-up, and recurrence. RESULTS One hundred and twenty-one (72 revision and 49 primary) cases were retrieved with a minimum follow-up of 1 year. Revision cases have significantly higher Krouse staging (P = 0.003), different distribution of tumor attachment sites, and higher recurrence rates. The recurrence rate was 4.1% for primary cases (mean follow-up 35.5 months) and 18.1% for revision cases (mean follow-up 45 months). Eight of the recurrent cases recurred within the first year. 5-fluorouracil was applied postoperatively in 18 (5 primary and 13 revision) cases, which included one (5.6%) recurrence and one minor complication (transient periorbital swelling). CONCLUSION The most important factors in preventing the recurrence of inverted papilloma are the determination of the location of the attachment and the completeness of resection in the primary endoscopic surgery. Revision cases have a higher recurrence rate, and the attachment sites are surgically more challenging. The use of 5-FU might have a place in the postoperative treatment of surgically challenging inverted papilloma. LEVEL OF EVIDENCE 4.
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Affiliation(s)
| | - Keng-Hua Lim
- Department of Otorhinolaryngology, Tan Tock Seng Hospital, Singapore
| | - Christos Georgalas
- Department of Otorhinolaryngology, Academic Medical Center, Amsterdam, The Netherlands
| | - Susanne M Reinartz
- Department of Otorhinolaryngology, Academic Medical Center, Amsterdam, The Netherlands
| | - Wytske J Fokkens
- Department of Otorhinolaryngology, Academic Medical Center, Amsterdam, The Netherlands
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Abstract
External approaches to the paranasal sinuses are rarely used in the endoscopic era. However, their indications for use have not changed, and in every surgeon's career those indications may present themselves. For residents training in the endoscopic era, these procedures are also very rarely seen. In this article, the external approaches to the maxillary, ethmoid, and frontal sinuses are described: their original descriptions, modern use, and potential complications. It is hoped that this article will serve to instruct residents and practitioners alike in these techniques.
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Rivera T, Rodríguez M, Pulido N, García-Alcántara F, Sanz L. Current indications for the osteoplastic flap. ACTA OTORRINOLARINGOLOGICA ESPANOLA 2015; 67:33-9. [PMID: 26025354 DOI: 10.1016/j.otorri.2015.01.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2014] [Revised: 01/15/2015] [Accepted: 01/25/2015] [Indexed: 11/16/2022]
Abstract
INTRODUCTION AND OBJECTIVES Endoscopic sinus surgery is the technique of choice in most of the frontal sinus diseases, both inflammatory and tumour-related. This is why the external approach using osteoplastic flap (OF) would be limited to cases with a difficult endoscopic approach. Our aim was to review the current indications of the osteoplastic flap in the treatment of frontal sinus pathology, through a retrospective study of patients undergoing this technique. METHODS We performed a retrospective study of 14 patients who were treated with the osteoplastic flap procedure. All the surgical indication criteria, type of sinus disease, presence or absence of prior endoscopic surgery, surgical findings, complications and recurrence were reviewed. RESULTS The pathologies found were 1 osteoma (7.1%), 3 inverted papilloma (21.4%) and 10 mucoceles (71.4%). Nine patients had a prior endoscopic surgery and 10 patients had an orbital dehiscence (9 mucocele, 1 papilloma). Frontal osteoma was Grade IV and the papilloma cases were Krouse Stage III. Surgical revision was required for 21.4%. CONCLUSIONS The main indications for an OF in patients with inflammatory disease are lateral extension and frontal recess neo-osteogenesis. In osteoma cases, it depends on the size of the tumour. In inverted papilloma cases, the indication is multifocal implantation with origin in the anterior and lateral wall. In all cases, performing the osteoplastic flap must be individualised.
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Affiliation(s)
- Teresa Rivera
- Servicio de Otorrinolaringología, Hospital Universitario Príncipe de Asturias, Universidad de Alcalá, Alcalá de Henares, Madrid, España.
| | - Manuel Rodríguez
- Servicio de Otorrinolaringología, Hospital Universitario Príncipe de Asturias, Universidad de Alcalá, Alcalá de Henares, Madrid, España
| | - Natalia Pulido
- Servicio de Otorrinolaringología, Hospital Universitario Príncipe de Asturias, Universidad de Alcalá, Alcalá de Henares, Madrid, España
| | - Fernando García-Alcántara
- Servicio de Otorrinolaringología, Hospital Universitario Príncipe de Asturias, Universidad de Alcalá, Alcalá de Henares, Madrid, España
| | - Lorena Sanz
- Servicio de Otorrinolaringología, Hospital Universitario Príncipe de Asturias, Universidad de Alcalá, Alcalá de Henares, Madrid, España
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Patel AB, Cain RB, Lal D. Contemporary applications of frontal sinus trephination: A systematic review of the literature. Laryngoscope 2015; 125:2046-53. [PMID: 25688730 DOI: 10.1002/lary.25206] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2014] [Revised: 01/12/2015] [Accepted: 01/21/2015] [Indexed: 11/06/2022]
Abstract
Our objective was to perform a systematic review of the literature on contemporary indications and outcomes for frontal sinus trephination and present an illustrative case of an endoscopically assisted repair of a subcutaneous frontal sinus fistula by trephination technique. PubMed and Ovid databases were used as data sources. A systematic review of the English literature was completed to review reports of frontal trephination from 1980 to 2014. Articles meeting inclusion criteria for inflammatory and noninflammatory indications were reviewed. Articles were systematically reviewed and graded by evidence-based medicine level. An illustrative case from our institution is then presented. The systematic review identified 2,621 published studies. Thirty-eight studies were identified for inclusion. The indications, techniques, outcomes, safety, and complications were reviewed for noninflammatory and inflammatory conditions. There were 32 retrospective case series, reports, or cohort studies (level 4), four systematic reviews (level 3), one prospective analysis (level 3), and one meta-analysis (level 2). Due to the heterogeneity of study cases and inclusion criteria, a meta-analysis was not feasible. We also present a novel closure of an anterior skull base defect resulting in a subcutaneous fistula with use of a frontal trephination approach. The frontal sinus trephination should not be regarded as a procedure of the past, as it useful in the armamentarium of the modern sinus and skull base surgeon. This approach provides access for instrumentation for hard-to-reach frontal sinus disease either purely through a trephination approach or as a supplementation to the transnasal endoscopic approach. Evidence supporting frontal sinus trephination is of levels 2, 3, and 4. Level of evidence: NA.
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Affiliation(s)
- Alpen B Patel
- Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Phoenix, Arizona, U.S.A
| | - Rachel B Cain
- Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Phoenix, Arizona, U.S.A
| | - Devyani Lal
- Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Phoenix, Arizona, U.S.A
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Ochsner MC, DelGaudio JM. The place of the osteoplastic flap in the endoscopic era: indications and pitfalls. Laryngoscope 2014; 125:801-6. [PMID: 25417859 DOI: 10.1002/lary.25014] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2014] [Revised: 10/09/2014] [Accepted: 10/15/2014] [Indexed: 11/09/2022]
Abstract
OBJECTIVES/HYPOTHESIS To evaluate the osteoplastic flap (OPF) procedure for frontal sinus pathology at our institution, including indications, revisions, obliteration vs. nonobliteration, and obliteration materials. STUDY DESIGN Single-institution retrospective review from 1998 to 2013. METHODS Current Procedural Terminology codes identified all OPF procedures. Demographic data, diagnoses, previous frontal procedures, obliteration materials, and outcomes were evaluated. Diagnoses were divided into two groups: inflammatory (refractory sinusitis, mucoceles, surgical material infections) and noninflammatory (tumors, cerebrospinal fluid leaks). RESULTS Fifty-seven patients underwent 73 OPF procedures: 36 obliterative and 37 nonobliterative/unobliterative. Inflammatory indications accounted for 76% of obliterated patients, but only 38% of nonobliterative procedures. Ten patients (17.5%) required revision, 90% of whom had an OPF for inflammatory indications. Only one patient who underwent an OPF procedure for noninflammatory pathology required revision. Twenty-four percent of patients obliterated with bone cement ultimately required complete removal to resolve infection. CONCLUSIONS The OPF approach is still valuable for pathology refractory to or inaccessible to endoscopic approaches. Infectious etiologies have a much higher revision rate. Careful selection of pathologies can reduce revision rates, but in some cases a repeated OPF procedure is the only viable alternative. When bone cement becomes infected the only resolution is complete removal.
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36
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Kopelovich JC, Baker MS, Potash A, Desai L, Allen RC, Chang EH. The hybrid lid crease approach to address lateral frontal sinus disease with orbital extension. Ann Otol Rhinol Laryngol 2014; 123:826-30. [PMID: 24944279 DOI: 10.1177/0003489414538767] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE This study aimed to describe the hybrid lid crease approach in conjunction with functional endoscopic sinus surgery (FESS) for lateral frontal sinus disease with orbital extension. STUDY DESIGN Retrospective case review. METHODS Patients undergoing hybrid lid crease approach with FESS for frontal sinus disease were reviewed retrospectively. Surgical indications consisted of inverting papilloma with extension into the frontal sinus (n = 1) and frontal sinus mucocele (n = 2). Inclusion criteria included presence of disease in the lateral frontal sinus with extension into the orbital space and erosion of the superior orbital rim. Preoperative and postoperative parameters included complete ophthalmologic exam, endoscopic exam, and computed tomography scan. RESULTS We were able to access the frontal sinus and orbit in all 3 cases and address sinus pathology of the lateral frontal sinus and orbit using the lid crease approach with FESS. All patients had improvement in ophthalmologic symptoms and interval disease resolution and were satisfied with their postoperative lid crease incision. CONCLUSION The lid crease approach offers direct access to the frontal sinus with minimal dissection through a well-hidden incision. In our case series of lateral frontal sinus pathology with orbital extension, the hybrid lid crease approach with FESS allowed complete eradication of disease without recurrence.
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Affiliation(s)
- Jonathan C Kopelovich
- Department of Otolaryngology-Head and Neck Surgery, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
| | - Meredith S Baker
- Department of Ophthalmology and Visual Sciences, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
| | - Andrea Potash
- Department of Ophthalmology and Visual Sciences, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
| | - Lajja Desai
- Roy J. and Lucille A. Carver College of Medicine, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
| | - Richard C Allen
- Department of Ophthalmology and Visual Sciences, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
| | - Eugene H Chang
- Department of Otolaryngology-Head and Neck Surgery, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
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Sciarretta V, Fernandez IJ, Farneti P, Pasquini E. Endoscopic and combined external-transnasal endoscopic approach for the treatment of inverted papilloma: analysis of 110 cases. Eur Arch Otorhinolaryngol 2013; 271:1953-9. [PMID: 24264764 DOI: 10.1007/s00405-013-2817-1] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2013] [Accepted: 11/05/2013] [Indexed: 11/26/2022]
Abstract
The aim of the study was to evaluate the effectiveness of the endoscopic approach for the management of inverted papilloma (IP) of the nose and paranasal sinuses and the possible factors associated with its recurrence. One hundred and forty-one patients affected by an IP originating at the level of the sinonasal tract were treated surgically using an endoscopic technique alone or a combined external-endoscopic approach at the ENT Department of the University of Bologna between January 1994 and December 2012. Of these patients, 110 were selected for the recurrence analysis. Univariate and multivariate analyses were performed to detect risk factors for IP recurrence. The patients had a mean follow-up of 56.7 months (24-167 months). Seven cases (6.3%) of recurrence were observed in patients treated with the endoscopic approach for the primary or recurrent tumor. Previous surgery (p = 0.005) and number of previous surgical procedures (p = 0.003) were associated with higher recurrence rate. The number of previous operations was associated to recurrence-free survival at Cox regression analysis. In our study, the endoscopic approach showed itself to be a useful tool for the radical resection of an IP. The endoscopic approach should be tailored for the different extensions of IP. Recurrent cases showed an increased risk of further recurrence. Therefore, these should be treated paying particular attention to the boundaries of the primary tumor.
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Affiliation(s)
- Vittorio Sciarretta
- ENT Department, University of Bologna, Ospedale Sant'Orsola-Malpighi, Bologna, Italy
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Five 'nontraditional' techniques for use in patients with recalcitrant sinusitis. Curr Opin Otolaryngol Head Neck Surg 2013; 21:39-44. [PMID: 23262744 DOI: 10.1097/moo.0b013e32835bf65b] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE OF REVIEW Although endoscopic sinus surgery remains the mainstay of surgical approaches to treating paranasal sinus disease, some disease may require alternative approaches. We review here five techniques: endoscopic middle turbinectomy, maxillary sinoscopy, the Caldwell-Luc procedure, intranasal inflammatory polyp steroid injection, and frontal sinus trephine. RECENT FINDINGS Recent findings suggest that endoscopic sinus surgery is limited in certain cases to access particular anatomic sites that may contain disease. The anterior, inferior maxillary wall and the frontal sinus may be accessed externally with minimal morbidity, and this access may be critical to treating the disease. The middle turbinate can contribute to preoperative and postoperative obstruction of sinus drainage, and resection of it can benefit the patient in many ways. Finally, the management of intranasal inflammatory polyps remains a challenge. In both preoperative and postoperative patients, the polyps may not respond to standard and even aggressive topical therapies. Intrapolyp steroid injection can provide a substantial anti-inflammatory effect and may avoid surgery for some patients. SUMMARY This article will review five ancillary procedures that add to the rhinologist's skill set to treat difficult or recalcitrant paranasal sinus disease.
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