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Sheth RK, Choudhary DA, Vishnurag A, Thomas I, Pandey R, Arvind I. Unusual Locations of Inverted Papilloma. Indian J Otolaryngol Head Neck Surg 2024; 76:2057-2061. [PMID: 38566729 PMCID: PMC10982235 DOI: 10.1007/s12070-023-04398-6] [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: 10/24/2023] [Accepted: 11/22/2023] [Indexed: 04/04/2024] Open
Abstract
Inverted papilloma is a tumor found involving the nasal cavity and paranasal sinuses. They are not cancerous but can be locally aggressive. They are most commonly seen involving the lateral wall of nose and maxillary sinus. When the tumor involves the frontal sinus and sphenoid sinus or the post ethmoid cells it presents a surgical challenge. Inverted papilloma almost always occur unilateraly and affect mainly the maxillary sinus. Inverted papilloma arising from the sphenoid and frontal sinuses are rare. Here we present two cases; one involving a 60 year man, with inverted papilloma originating from the frontal sinus and another case where it originated from the sphenoid sinus anterior wall and posterior ethmoidalcell (Onodi cell) and was resected endoscopically.
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Affiliation(s)
- Ritu K. Sheth
- Department of ENT, Seth V C Gandhi and M A Vora Muncipal General Hospital, Rajawadi, Mumbai India
| | - Deepika A. Choudhary
- Department of ENT, Seth V C Gandhi and M A Vora Muncipal General Hospital, Rajawadi, Mumbai India
| | - Athira Vishnurag
- Department of ENT, Seth V C Gandhi and M A Vora Muncipal General Hospital, Rajawadi, Mumbai India
| | - Irine Thomas
- Department of ENT, Seth V C Gandhi and M A Vora Muncipal General Hospital, Rajawadi, Mumbai India
| | - Roop Pandey
- Department of ENT, Seth V C Gandhi and M A Vora Muncipal General Hospital, Rajawadi, Mumbai India
| | - Isha Arvind
- Department of ENT, Seth V C Gandhi and M A Vora Muncipal General Hospital, Rajawadi, Mumbai India
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Vinciguerra A, Guichard JP, Verillaud B, Herman P. Extended sphenoidotomy combined with transpterygoid approach for sphenoidal sinus inverted papilloma. Eur Arch Otorhinolaryngol 2023; 280:5369-5378. [PMID: 37414940 DOI: 10.1007/s00405-023-08106-6] [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: 04/19/2023] [Accepted: 07/03/2023] [Indexed: 07/08/2023]
Abstract
PURPOSE Inverted papilloma of the sphenoid sinus (IPSS) is a rare tumor with debated surgical management due to its proximity to vital structures. The aim of this manuscript is to highlight the role of a transpterygoid approach (TPA) and pedicle-orientated strategy in case of involvement of critical structures in IPSS and compare it with data from the literature. METHODS Patients with primary IPSS between January 2000 and June 2021 were included. Pre-operative CT/MRI were analyzed to classify the pneumatization of the SS and predict the insertion point of the inverted papilloma. All patients were treated with a trans-sphenoidal approach which was combined with a TPA in case of lateral insertion point. A systematic search was also performed to summarize the available literature. RESULTS Twenty-two patients were treated for IPSS. By CT, the SS was categorized with type III pneumatization in 72.8% of cases. Eleven patients (50%) were treated with a TPA with a statistical association with the insertion point on the SS lateral wall (p = 0.01), rather than a SS pneumatization (p = 0.63). The overall success was 95.5% after a mean follow-up of 35.9 months. For the literature, 26 publications were included on 97 patients and described a trans-sphenoidal approach with a success rate of 84.6% after a mean follow-up of 24.5 months. CONCLUSION IPSS is generally treated with a sphenoidotomy approach, although in selected cases, a TPA should be preferred to expose the whole SS lateral wall though allowing a complete pedicled oriented resection of the tumor.
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Affiliation(s)
- Alessandro Vinciguerra
- Otorhinolaryngology and Skull Base Center, AP-HP, Hospital Lariboisière, 2 Rue Ambroise Paré, 75010, Paris, France.
| | | | - Benjamin Verillaud
- Otorhinolaryngology and Skull Base Center, AP-HP, Hospital Lariboisière, 2 Rue Ambroise Paré, 75010, Paris, France
| | - Philippe Herman
- Otorhinolaryngology and Skull Base Center, AP-HP, Hospital Lariboisière, 2 Rue Ambroise Paré, 75010, Paris, France
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Ho AKH, Brinkman D, Khan MH. Inverted papilloma of the sphenoid sinus – A case report. OTOLARYNGOLOGY CASE REPORTS 2020. [DOI: 10.1016/j.xocr.2020.100173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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Zeng J, Liu H, Liu L, Liao W, Hu P, Wang X, Li X, Sun L, Zhang Y, Yi X. Fibrosarcoma arising in the paranasal sinus: a clinicopathological and radiological analysis. Dentomaxillofac Radiol 2018; 47:20170459. [PMID: 29658783 DOI: 10.1259/dmfr.20170459] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVES To analyze the clinicopathological features and the CT and MRI features of patients with paranasal sinus fibrosarcoma. METHODS Seven patients with surgically and pathologically confirmed paranasal sinus fibrosarcoma were enrolled. Their CT and MRI data and imaging features were retrospectively analyzed in detail. RESULTS The study participants were two males and five females (median age, 43 years; range, 22-73 years). CT or MRI showed a well-defined (n = 5) or ill-defined (n = 2), irregular (n = 6) or oval (n = 1) mass, with heterogeneous (n = 7) density. The lesions were isointense (n = 4) or hypointense (n = 2) on T1 weighted images, and showed heterogeneous (n = 6) mild hypointensity on T2 weighted images. Expansive (n = 6) and osteolytic (n = 1) bone destruction were observed. The tumors showed marked heterogeneous delayed enhancement (n = 6) on contrast-enhanced MRI images. CONCLUSION Paranasal sinus fibrosarcomas should be included in the differential diagnosis when a sinonasal neoplasm appears as a well- or ill-defined unilateral large irregular mass with characteristic mild hypointensity on T2 weighted MR images and shows expansive or osteolytic bone destruction and a marked heterogeneous delayed contrast-enhancement pattern.
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Affiliation(s)
- Junjie Zeng
- 1 Department of Radiology, Xiangya Hospital, Central South University , Changsha , China
| | - Huaping Liu
- 1 Department of Radiology, Xiangya Hospital, Central South University , Changsha , China
| | - Lizhi Liu
- 2 Department of Imaging Diagnosis Center, Sun Yat-sen University Cancer Center , Guangzhou , China
| | - Weihua Liao
- 1 Department of Radiology, Xiangya Hospital, Central South University , Changsha , China
| | - Ping Hu
- 1 Department of Radiology, Xiangya Hospital, Central South University , Changsha , China
| | - Xiaoyi Wang
- 1 Department of Radiology, Xiangya Hospital, Central South University , Changsha , China
| | - Xuejun Li
- 3 Department of Neurosurgery, Xiangya Hospital, Central South University , Changsha , China
| | - Lunquan Sun
- 4 Center for Molecular Medicine,Xiangya Hospital, Central South University , Changsha , China
| | - Youming Zhang
- 1 Department of Radiology, Xiangya Hospital, Central South University , Changsha , China
| | - Xiaoping Yi
- 1 Department of Radiology, Xiangya Hospital, Central South University , Changsha , China
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Fakhri S, Citardi MJ, Wolfe S, Batra PS, Prayson RA, Lanza DC. Challenges in the Management of Sphenoid Inverted Papilloma. ACTA ACUST UNITED AC 2018. [DOI: 10.1177/194589240501900216] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background Inverted papilloma (IP) arising in the sphenoid sinus is extremely rare. Management of sphenoid sinus IP is especially challenging because of the paucity of sinonasal symptoms on presentation and the inherent surgical risks associated with the anatomic location of the sphenoid sinus. Methods We performed a retrospective review of medical records of all patients with IP arising within the sphenoid sinus. Results A total of five patients were identified. All patients were managed with endoscopic resection. The most common presenting symptom was headache (three patients). The mean follow-up period was 37.6 months (range, 10–79 months). Two patients with erosive skull base lesions adjacent to the internal carotid artery were managed with a staged endoscopic resection. Only one patient developed a recurrence after 38 months and underwent revision endoscopic resection. Conclusions Endoscopic management of sphenoid IP allows maximal resection with minimal morbidity and facilitates endoscopic postoperative surveillance. Complete preoperative radiological assessment of tumor extent is essential. Preoperative medical therapy can help normalize inflamed mucosa and minimize intraoperative bleeding. For large erosive IP, surgical risks may be minimized by considering a staged resection and using computer-aided surgery.
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Affiliation(s)
- Samer Fakhri
- Rhinology and Sinonasal Surgery University of Texas Medical School, Houston, Texas
| | | | - Stephen Wolfe
- Department of Otolaryngology–Head and Neck Surgery, University of Pennsylvania, Philadelphia, Pennsylvania
| | | | - Richard A. Prayson
- Department of Anatomic Pathology, Cleveland Clinic Foundation, Cleveland, Ohio
| | - Donald C. Lanza
- St. Anthony's Carillon Outpatient Center, St. Petersburg, Florida
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Wassef SN, Batra PS, Barnett S. Skull base inverted papilloma: a comprehensive review. ISRN SURGERY 2012; 2012:175903. [PMID: 23346418 PMCID: PMC3549337 DOI: 10.5402/2012/175903] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/02/2012] [Accepted: 10/17/2012] [Indexed: 11/23/2022]
Abstract
Skull base inverted papilloma (IP) is an unusual entity for many neurosurgeons. IP is renowned for its high rate of recurrence, its ability to cause local destruction, and its association with malignancy. This paper is a comprehensive review of the reports, studies, and reviews published in the current biomedical literature from 1947 to September 2010 and synthesize this information to focus on its potential invasion to the base of the skull and possible intradural extension. The objective is to familiarize the clinician with the different aspects of this unusual disease. The role of modern diagnostic tools in medical imaging in order to assess clearly the limits of the tumors and to enhance the efficiency and the safety in the choice of a surgical approach is pointed out. The treatment guidelines for IP have undergone a complex evolution that continues today. Radical excision of the tumour is technically difficult and often incomplete. Successful management of IP requires resection of the affected mucosa which could be achieved with open surgery, endoscopic, or combined approach. Radio and chemotherapy were used for certain indications. More optimally research would be a multicenter randomized trials with large size cohorts.
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Affiliation(s)
- Shafik N Wassef
- Department of Neurosurgery, University of Iowa Hospitals and Clinics, Iowa City, IA 52242, USA ; McConnell Brain Imaging Center, Montreal Neurological Institute and Hospital, McGill University, Montreal, QC, Canada H3A 2B4 ; Department of Neurology and Neurosurgery, McGill University, Montreal, QC, Canada H3A 2B4
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Guillemaud JP, Witterick IJ. Inverted papilloma of the sphenoid sinus: clinical presentation, management, and systematic review of the literature. Laryngoscope 2009; 119:2466-71. [PMID: 19798734 DOI: 10.1002/lary.20718] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
OBJECTIVES Inverted papilloma (IP) of the sphenoid sinus is a rare neoplasm with a nonspecific and insidious presentation that is further complicated by difficult access for assessment and follow-up. In conjunction with a systematic review of the English literature, we review our experience with IP of the sphenoid sinus to better delineate the clinical presentation, prevalence, management, and recurrence of this challenging lesion. METHODS A systematic search strategy was developed to assess and summarize the best available evidence on sphenoid IP. A retrospective chart review of the 5-year database of one tertiary care Otolaryngology-Head and Neck Surgery practice was performed; all patients with histologically confirmed IP of the nasal cavity or paranasal sinuses were included. RESULTS Seventy-one patients (49 males, 22 females; mean age, 57.2 years) treated between June 2003 and January 2009 were included. Nine patients were diagnosed with IP originating in the sphenoid sinus. Two of these patients were asymptomatic, and in the remaining seven patients the most common presentation was headache (42.9%), followed by visual disturbances, hearing loss, and nasal obstruction (28.6% each). Review of the literature confirms our finding that the most common presenting symptom is headache (45.0%), followed by nasal obstruction (30.0%) and epistaxis (22.5%). CONCLUSIONS This is the largest reported series of sphenoid sinus IP in the English literature. We have demonstrated a predominance of neurological and visual symptoms in symptomatic patients with sphenoid IP, and suggest that these may be early manifestations of sphenoid IP, before the more common sinonasal symptoms develop secondary to extension into the nasal cavity and paranasal sinuses.
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Affiliation(s)
- Jennifer P Guillemaud
- Department of Otolaryngology-Head and Neck Surgery, Mount Sinai Hospital, Toronto, Ontario, Canada
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Cho HJ, Kim JK, Kim K, Kim YS, Lee JG, Yoon JH. Endoscopic surgery for inverted papilloma originating from the sphenoid sinus and related clinical characteristics. Acta Otolaryngol 2008; 128:1120-5. [PMID: 18607986 DOI: 10.1080/00016480701874469] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
CONCLUSIONS Bony changes on CT imaging of inverted papilloma (IP) are useful for predicting tumor origin and recurrence sites. Because the lateral wall and floor of the sphenoid sinus are the most common origin and recurrence sites, the anterior wall of the sphenoid sinus should be opened as wide as the lateral wall and inferiorly to the level of the floor, especially in deeply pneumatized sphenoid sinuses. OBJECTIVES The incidence of isolated sphenoid IP is exceedingly low. So far, there have not been studies on the usual origin and recurrence sites of the sphenoid sinus. We sought to identify the sites of origin and recurrence and describe clinical characteristics, radiological features, and proper endoscopic management. PATIENTS AND METHODS We retrospectively reviewed medical records of patients with IP of the sphenoid sinus. Data collection included clinical presentations, origin and recurrent sites, radiological features, and surgical methods. RESULTS Seven patients were identified. The most common symptoms were headache and nasal obstruction. Radiological findings showed that most tumors extended into the nasal cavity or ethmoid sinus combined frequently with erosion of the lateral wall or intersinus septum. We noted simultaneous attachment to multiple walls in five subjects, including both lateral wall and floor attachment in three subjects.
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Kosugi EM, Santos RDP, Ganança FF, Tangerina RDP, Suguri VM, Yamaoka WY, Gregório LC. Inverted papilloma in the sphenoethmoidal recess. Braz J Otorhinolaryngol 2008; 74:151-4. [PMID: 18392518 PMCID: PMC9450681 DOI: 10.1016/s1808-8694(15)30767-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2005] [Accepted: 05/24/2005] [Indexed: 11/26/2022] Open
Abstract
Inverted papilloma is a nasal benign tumor that usually arises from the lateral nasal wall, especially from the middle meatus. It has high local invasive likelihood, high recurrence rates and malignancy potential. Sphenoethmoidal recess involvement is rare and is usually due to sphenoid sinus primary disease. In the literature, no case of isolated sphenoethmoidal recess inverted papilloma has been reported yet. The present report describes an exceptional location of inverted papilloma, arising from the sphenoethmoid recess, without involving the sphenoid sinus.
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Eisen MD, Buchmann L, Litman RS, Kennedy DW. Inverted papilloma of the sphenoid sinus presenting with auditory symptoms: a report of two cases. Laryngoscope 2002; 112:1197-200. [PMID: 12169898 DOI: 10.1097/00005537-200207000-00010] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES The report aims to inform the reader of cases of inverted papilloma involving the sphenoid sinus presenting with auditory symptoms. STUDY DESIGN Case series. METHODS A retrospective medical record analysis was carried out to identify patients with inverted papilloma involving the sphenoid sinus that presented with a primary complaint of hearing loss or tinnitus, or both. Clinical records, including initial history and physical examination, audiologic and radiologic studies, and operative and histopathologic reports, were carefully examined. A complete literature review for relevant studies was performed to explore possible pathophysiologic factors and similar cases. RESULTS Two patients with inverted papilloma presenting with primary auditory complaints were identified. One patient had roaring tinnitus and sensorineural hearing loss demonstrated with audiologic assessment, whereas the other had pulsatile tinnitus. Both patients had biopsy-proven inverted papilloma involving the sphenoid sinus, and both patients underwent endoscopic resection of the disease. No other cause or origin of their auditory symptoms was confirmed. The auditory symptoms of both patients improved markedly after excision of their inverted papillomas. CONCLUSIONS Tinnitus with or without hearing loss is an unusual presentation of inverted papilloma of the sphenoid sinus. Sphenoid tumors should be considered in the workup of these symptoms.
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Affiliation(s)
- Marc D Eisen
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania Medical Center, Philadelphia 19104, U.S.A.
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