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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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Baser B, Mishra A, Chaubey P. Endoscopic Modified Danker's Approach for Management of Sinonasal Inverted Papilloma: Our Experience. Indian J Otolaryngol Head Neck Surg 2021; 73:282-289. [PMID: 34471615 DOI: 10.1007/s12070-020-02090-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Accepted: 08/21/2020] [Indexed: 10/23/2022] Open
Abstract
Sinonasal inverted papilloma (SNIP), Inverting papilloma, Schneiderian papilloma etc. It is a benign tumor with incidence nearly 70% of all sinonasal papilloma and 0.5-4.0% of all sinonasal neoplasms. The most common site of origin is lateral nasal wall and common presenting symptom is nasal obstruction followed by epistaxis. On histopathology examination, it is characterized by invagination of neoplastic epithelium into underlying stroma. With the advent of technology, the endoscopic modified dankers approach became the surgical approach of choice. The present study was undertaken to study its role in management of SNIP with reference to rate of recurrence and malignancy. An observational study was conducted in a tertiary health center in which 40 biopsy proven cases of SNIP, operated by endoscopic assisted modified Danker's approach between September 2008 and January 2019 with minimum follow-up period of 6 months were analyzed. Male:Female ratio was 2.33:1. The most common symptom was nasal obstruction (97.5%) followed by rhinorrhoea (87.5%). Using various imaging and diagnostic measures, lateral nasal wall was found to be the most common site of origin. Out of total 40 cases, 9 (27.5%) patients had recurrence, of these, 6 were benign and remaining 3 had malignancy as confirmed by biopsy. Most of the cases of SNIP can be managed endoscopically, although extensive lesions or the lesions with malignant transformation, external approach may be needed so expertise in both endoscopic and conventional techniques is needed. Although most of the recurrences occurred in first 2 years, but life time follow-up is advisable.
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Affiliation(s)
- Brajendra Baser
- Department of Otorhinolaryngology and Head and Neck Surgery, Sri Aurobindo Medical College and Post Graduate Institute, Sanwer Road, Indore, M.P 453555 India.,Akash ENT Hospital, Indore, M.P India
| | - Ankit Mishra
- Department of Otorhinolaryngology and Head and Neck Surgery, Sri Aurobindo Medical College and Post Graduate Institute, Sanwer Road, Indore, M.P 453555 India
| | - Priya Chaubey
- Department of Otorhinolaryngology and Head and Neck Surgery, Sri Aurobindo Medical College and Post Graduate Institute, Sanwer Road, Indore, M.P 453555 India
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He X, Wang Y. Clinical characteristics of sinonasal inverted papilloma associated with recurrence and malignant transformation. Auris Nasus Larynx 2021; 48:1105-1108. [PMID: 33965286 DOI: 10.1016/j.anl.2021.04.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Revised: 04/05/2021] [Accepted: 04/15/2021] [Indexed: 12/26/2022]
Abstract
OBJECTIVE Sinonasal inverted papilloma is a benign tumor but has a potential for recurrence and malignant transformation. The aim of this article is to analyze the clinical characteristics of sinonasal inverted papilloma associated with recurrence and malignant transformation. MATERIAL AND METHODS A retrospective study was performed in all patients with sinonasal inverted papilloma diagnosed between in our hospital during May 2013 and May 2018. RESULTS A total of 151 patients were enrolled in this study. The average age of these patients was 52.24 years, with a male-to-female ratio of 2.775:1, and the most frequent clinical symptom was nasal obstruction. The recurrence rate was 39.07% (59/151), the mean time of recurrence was 35.8 months and most recurrences occur within the first three years after surgery. There was no significant difference in recurrence rate between all four stages and between after endoscopic surgery and a combined endoscopic and external approach. The malignant transformation rate was 5.96% (9/151) and the mean time of malignant transformation was 9.06 months. CONCLUSIONS Because of its high recurrence rate and the potential of malignant transformation, so it is important to determine the primary site of the tumor and to make a complete removal and a follow-up of at least five years after surgery is recommended.
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Affiliation(s)
- Xindi He
- Department of Rhinology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - Ying Wang
- Department of Rhinology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China.
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Al Momen A, Alenzi HL, Al Eid M. Bilateral simultaneous sino-nasal inverted papilloma; A report of two cases and literature review. Int J Surg Case Rep 2020; 67:71-75. [PMID: 32028092 PMCID: PMC7005342 DOI: 10.1016/j.ijscr.2019.12.034] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Revised: 12/15/2019] [Accepted: 12/20/2019] [Indexed: 12/29/2022] Open
Abstract
Introduction Inverted Papilloma is a benign sinonasal tumor with a high recurrence rate and potential for malignant transformation, it typically presents as an obstructing unilateral nasal mass, atypical presentations include bilateral involvement which occurs in up to 5 % of cases. Case presentation Here we present two different cases of bilateral inverted papilloma, both presented complaining of bilateral nasal obstruction, the second case also had associated nasal polyposis and history of multiple previous endoscopic sinus surgeries, both cases were managed with endoscopic medial maxillectomy and tumor removal, with no signs of recurrence on follow up. Conclusion Bilateral involvement is an uncommon, atypical presentation of inverted papilloma, endoscopic surgery is a safe, reliable approach and it is the mainstay of treatment, regular endoscopic and clinical follow up is important for detection of recurrence.
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Affiliation(s)
- Ali Al Momen
- Consultant ENT, Rhinology and Skull Base Surgery at King Fahad Specialist Hospital, Dammam, Saudi Arabia
| | | | - Mohammad Al Eid
- ENT Resident, Saudi Commission of Health Specialties Eastern Province Program, Saudi Arabia
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Di Pietrantonio A, Asmus H, Ingratta C, Brennan W, Schulz J, Carballo L. [Invasive sinonasal papilloma with intracranial invasion: Case report and bibliographic review]. Surg Neurol Int 2018; 9:S29-S35. [PMID: 29430328 PMCID: PMC5799940 DOI: 10.4103/sni.sni_370_17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2017] [Accepted: 10/30/2017] [Indexed: 11/29/2022] Open
Abstract
INTRODUCTION Inverted papilloma is a locally-aggressive benign neoplasm of the paranasal sinuses with a high potential for recurrence and malignancy. Intracranial extension is infrequent, and dural penetration even more so, typically associated with recurrence of the disease or its degeneration into squamous cell carcinoma. CLINICAL CASE A 32-year-old female patient consulted us for an exophytic lesion in her right nostril and exophthalmos, associated with headache, anosmia and dysgeusia. Craniofacial and brain CT and brain MRI demonstrated a lesion in the right nostril, extending into the aerial sinuses, orbital lateral wall and anterior fossa, with osteolysis and intracranial invasion towards the right frontal region. A mass effect and brain compression were noted. A histological diagnosis of inverted papilloma was made initially. Upon later resection of the lesion by double access, with reconstruction of the anterior cranial fossa, a definitive diagnosis was made of inverted papilloma of the Schneiderian type, with areas of atypical transformation in situ. Post-operatively, the patient has had a favorable course, with full upper airway patency and neither complications nor signs of recurrence after four years of follow-up. CONCLUSIONS Intracranial invasion of this pathology is extremely uncommon. When it exists, the tumor has a high potential for local recurrence. Consequently, complete excision of the lesion determines the patient's prognosis.
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Affiliation(s)
- Andrés Di Pietrantonio
- Servicio de Neurocirugía, Hospital de Trauma y Emergencias Dr. Federico Abete, Malvinas Argentinas, Provincia de Buenos Aires, Argentina
| | - Humberto Asmus
- Servicio de Neurocirugía, Hospital de Trauma y Emergencias Dr. Federico Abete, Malvinas Argentinas, Provincia de Buenos Aires, Argentina
| | - Christian Ingratta
- Servicio de ORL, Hospital de Trauma y Emergencias Dr. Federico Abete, Malvinas Argentinas, Provincia de Buenos Aires, Argentina
| | - Walter Brennan
- Servicio de Neurocirugía, Hospital de Trauma y Emergencias Dr. Federico Abete, Malvinas Argentinas, Provincia de Buenos Aires, Argentina
| | - Javier Schulz
- Servicio de Neurocirugía, Hospital de Trauma y Emergencias Dr. Federico Abete, Malvinas Argentinas, Provincia de Buenos Aires, Argentina
| | - Leandro Carballo
- Servicio de Neurocirugía, Hospital de Trauma y Emergencias Dr. Federico Abete, Malvinas Argentinas, Provincia de Buenos Aires, Argentina
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Jeong J, Chung HJ, Yoon JH, Lee JG, Kim CH. Analysis of Histopathologic Characteristic and Treatment of Sinonasal Benign Tumor. JOURNAL OF RHINOLOGY 2017. [DOI: 10.18787/jr.2017.24.2.81] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Affiliation(s)
- Junhui Jeong
- Department of Otorhinolaryngology, National Health Insurance Service Ilsan Hospital, Goyang, Korea
| | - Hyo Jin Chung
- Department of Otorhinolaryngology, National Health Insurance Service Ilsan Hospital, Goyang, Korea
| | - Joo-Heon Yoon
- Department of Otorhinolaryngology, College of Medicine, Yonsei University, Seoul, Korea
| | - Jeung-Gweon Lee
- Department of Otorhinolaryngology, College of Medicine, Yonsei University, Seoul, Korea
| | - Chang-Hoon Kim
- Department of Otorhinolaryngology, College of Medicine, Yonsei University, Seoul, Korea
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Abstract
PURPOSE OF REVIEW Endoscopic sinus surgery became the gold standard in inflammatory disorders of the nose and paranasal sinuses, in cerebrospinal fluid leak and epistaxis management, and established its efficacy in the oncology of the region. However, there are certain limitations which make an external approach mandatory. This article reviews the recent literature describing the cases where an open procedure is still indicated. RECENT FINDINGS Despite the evolution of endoscopic surgery external approaches are still indicated. Osteoplastic flap remains an option for the refractory inflammation of the frontal sinus. Benign and malignant tumours with lateral or superior extension, neurovascular involvement, and bony/soft tissue erosion usually require an external approach. Superior and lateral posterior wall defects of frontal sinus with cerebrospinal fluid leak may mandate an open procedure. Management of severe epistaxis may still necessitate in selected cases an external approach when endoscopic surgery fails and embolization setting is not available. SUMMARY Although advances in endoscopic instrumentation and techniques steadily decrease the indications for external approaches, they continue to have a role in the management of nasal disorders. This study summarizes the recent literature and provides a comprehensive review of the up-to-date remaining indications for open procedures in the nose and paranasal sinuses.
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Endoscopic Modified Medial Maxillectomy for Resection of an Inverted Papilloma Originating from the Entire Circumference of the Maxillary Sinus. Case Rep Otolaryngol 2015; 2015:952923. [PMID: 26146581 PMCID: PMC4469785 DOI: 10.1155/2015/952923] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2015] [Accepted: 05/24/2015] [Indexed: 11/17/2022] Open
Abstract
For treatment of a sinonasal inverted papilloma (IP), it is essential to have a definite diagnosis, to identify its origin by computed tomography (CT) and magnetic resonance imaging (MRI), and to select the appropriate surgical approach based on the staging system proposed by Krouse. Recently, a new surgical approach named endoscopic modified medial maxillectomy (EMMM) was proposed. This approach can preserve the inferior turbinate and nasolacrimal duct. We successfully treated sinonasal IP with EMMM in a 71-year-old female patient. In this patient, the sinonasal IP originated from the entire circumference of the maxillary sinus. EMMM is not a difficult procedure and provides good visibility of the operative field. Lacrimation and empty nose syndrome do not occur postoperatively as the nasolacrimal duct and inferior turbinate are preserved. EMMM is considered to be a very favorable approach for treatment of sinonasal IP.
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9
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Clinical Outcomes of Endoscopic and Open Resection of Recurrent Sinonasal Inverted Papilloma. J Craniofac Surg 2014; 25:1090-3. [DOI: 10.1097/scs.0000000000000560] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Lee JT, Kingdom TT, Smith TL, Setzen M, Brown S, Batra PS. Practice patterns in endoscopic skull base surgery: survey of the American Rhinologic Society. Int Forum Allergy Rhinol 2013; 4:124-31. [DOI: 10.1002/alr.21248] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2013] [Revised: 09/22/2013] [Accepted: 09/26/2013] [Indexed: 11/08/2022]
Affiliation(s)
- Jivianne T. Lee
- Department of Otolaryngology-Head and Neck Surgery; David Geffen School of Medicine at University of California; Los Angeles (UCLA); Los Angeles CA
- Orange County Sinus Institute; Southern California Permanente Medical Group (SCPMG); Irvine CA
| | - Todd T. Kingdom
- Department of Otolaryngology; University of Colorado; Aurora CO
| | - Timothy L. Smith
- Department of Otolaryngology-Head and Neck Surgery; Oregon Health and Science University; Portland OR
| | - Michael Setzen
- New York University School of Medicine; New York NY
- Department of Otolaryngology; North Shore University Hospital; Manhasset NY
| | - Seth Brown
- Division of Otolaryngology; University of Connecticut School of Medicine; Hartford CT
- Connecticut Sinus Institute; Hartford CT
| | - Pete S. Batra
- Department of Otolaryngology-Head and Neck Surgery; University of Texas Southwestern Medical Center; Dallas TX
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11
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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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12
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Pitak-Arnnop P, Bertolini J, Dhanuthai K, Hendricks J, Hemprich A, Pausch NC. Intracranial extension of Schneiderian inverted papilloma: a case report and literature review. GERMAN MEDICAL SCIENCE : GMS E-JOURNAL 2012; 10:Doc12. [PMID: 22737105 PMCID: PMC3380239 DOI: 10.3205/000163] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/11/2012] [Indexed: 11/30/2022]
Abstract
Inverted papilloma is an uncommon primary nasal tumor. Despite its benign nature, this tumor represents three typical characteristics: a high propensity of recurrence, local aggressiveness and association with malignancy. Inverted papilloma can reduce the patient’s quality of life due to compromised nasal function, extension to the orbit and brain. The authors reported the unusual case of a 72-year-old male patient with inverted papilloma, which fatally extended to the intracranial temporal fossa after multiple recurrences. To the authors’ knowledge, this is the twelfth case in the literature of inverted papilla extending into the temporal fossa. The current and pertinent literature in English, French and German was reviewed, and an algorithm for managing inverted papilloma was also proposed.
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Affiliation(s)
- Poramate Pitak-Arnnop
- Department of Oral, Craniomaxillofacial and Facial Plastic Surgery, University Hospital of Leipzig, Leipzig, Germany.
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13
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New anatomic division of the orbital and sinus regions: guidance for nasal endoscopic resection of space-occupying lesions. J Craniofac Surg 2012; 22:2000-5. [PMID: 22075811 DOI: 10.1097/scs.0b013e3182319630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
The significance of anatomic divisions of the orbital and sinus regions in providing guidance for nasal endoscopic resection of benign space-occupying lesions was discussed. This retrospective study included 177 cases with benign space-occupying lesions of the orbital and sinus resected between 2001 and 2009. Locations of lesions were assigned to 3 anatomic categories. The 63 cases of benign lesions of the sphenoethmoid-orbital region underwent nasal endoscopic resection. In the 31 cases of benign lesions in the frontoethmoid-orbital region, surgical approaches included nasal endoscopy (n = 15) and combined endoscopic and external (n = 9) and external approaches (n = 4). In 87 cases of lesions in the axillae-ethmoid-orbital region, surgical approaches included nasal endoscopy (n = 67), combined approaches (n = 15), and external approaches (n = 5). Endoscopy facilitated the resection of both 63 cases of benign lesions of sphenoethmoid-orbital region, and 82 cases of benign lesions of the frontoethmoid-orbital and maxillae-ethmoid-orbital regions with good prognosis. However, the procedure was relatively more difficult for the other 32 cases of benign lesions of the frontoethmoid-orbital or maxillae-ethmoid-orbital regions. The feasibility of nasal endoscopic resection differs markedly according to anatomic location. Preoperative classification of the site of the lesions will help to define the indications for nasal endoscopic resection of the orbital and sinus regions.
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Clinical significance of programmed cell death 4 expression in malignant progression of human nasal inverted papillomas. Med Oncol 2012; 29:2505-11. [PMID: 22359108 DOI: 10.1007/s12032-012-0185-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2012] [Accepted: 02/03/2012] [Indexed: 02/08/2023]
Abstract
Programmed cell death 4 (PDCD4) is a novel tumor suppressor gene that can inhibit tumor neoplastic transformation and progression in cultured cells and gene knock-out mouse models. Lost or decreased PDCD4 expression has been associated with progression and prognosis of multiple types of human tumors. However, the expression and clinical significance of PDCD4 in nasal inverted papillomas (NIPs) has not been investigated. We compared PDCD4 expression in 64 samples of NIPs, 23 of associated squamous cell carcinomas (SCCs), and 19 normal nasal samples at mRNA and protein levels by RT-PCR, western blot analysis, and immunohistochemistry. PDCD4 mRNA expression was reduced in 52% of NIP frozen samples (13/25), and the protein level was diminished in 56.3% of samples (36/64) as compared with 19 normal nasal samples, which expressed high levels of PDCD4 mRNA and protein. Furthermore, altered expression of PDCD4 was associated with the clinicopathological features Krouse stage and dysplasia. Importantly, we found a strong negative correlation of PDCD4 expression and Ki-67 labeling index in NIPs (r=-0.6645, p<0.001). In addition, the 3 tissue-sample groups significantly differed in PDCD4 expression and Ki-67 labeling index. Thus, PDCD4 expression may play a key role in pre-cancerous lesions of human NIPs and may help predict malignant progression from benign nasal tumors to associated SCC.
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Harvey RJ, Winder M, Parmar P, Lund V. Endoscopic skull base surgery for sinonasal malignancy. Otolaryngol Clin North Am 2012; 44:1081-140. [PMID: 21978897 DOI: 10.1016/j.otc.2011.06.020] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Management of malignant neoplasms of the sinonasal tract and skull base is hampered by the relative low incidence and pathologic diversity of patient presentations. Many studies have reported successful outcomes in the endoscopic management of malignancy since 1996, and these are summarized in this article. Nonsurgical adjuvant therapies are important for locoregional control because surgery occurs in a restricted anatomic space with close margins to critical structures, and distant disease is an ongoing concern in these disorders. There remains a need for collaborative consistent multicenter reporting, and international registries have been established to assist in such efforts.
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Affiliation(s)
- Richard J Harvey
- Department of Otolaryngology/Skull Base Surgery, St Vincent's Hospital, Victoria Street, Darlinghurst, Sydney, New South Wales 2010, Australia.
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16
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Komplikation bei der Operation eines invertierten Papilloms. Rechtsmedizin (Berl) 2011. [DOI: 10.1007/s00194-011-0782-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Hughes OR, Skilbeck CJ, Kwame I, Kwa K, Choa DI. Suction diathermy as an adjunct to endoscopic removal of inverted papilloma. Laryngoscope 2011; 121:997-8. [PMID: 21520114 DOI: 10.1002/lary.21436] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Owain R Hughes
- Royal National Throat Nose and Ear Hospital, University College London, London, United Kingdom.
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Tomazic PV, Stammberger H, Habermann W, Schmid C, Koele W, Mokry M, Gellner V, Beham A. Aggressive inverted papilloma with intracranial invasion and short malignization time. SKULL BASE REPORTS 2011; 1:111-4. [PMID: 23984212 PMCID: PMC3743604 DOI: 10.1055/s-0031-1280738] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/09/2011] [Accepted: 03/28/2011] [Indexed: 11/09/2022]
Abstract
Inverted papillomas (IP) are considered benign lesions with a prevalence up to 4% among all sinunasal tumors; however, invasive growth and varying tendency for malignization are reported in literature. We report the case of a 69-year-old woman suffering from a large, aggressively growing IP invading the orbit, skull base, and frontal lobe of the brain. Within only 3 months' time the papilloma showed transformation into an invasive carcinoma, leaving surgical therapy in vain due to explosive recurrence. Intracranial and intraorbital expansion by IP is possible despite histology not showing signs of malignancy initially. In “regular” IP close endoscopic follow-up is mandatory to not overlook recurrence harboring malignancy.
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Affiliation(s)
- Peter Valentin Tomazic
- Department for General Otolaryngology, Head and Neck Surgery, Medical University Graz, Graz, Austria
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Weber RK, Werner JA, Hildenbrand T. Endonasal endoscopic medial maxillectomy with preservation of the inferior turbinate. Am J Rhinol Allergy 2011; 24:132-5. [PMID: 21144217 DOI: 10.2500/ajra.2010.24.3531] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND Endonasal endoscopic medial maxillectomy usually includes removal of the inferior turbinate (IT) even if it is not involved in the disease. A surgical approach is presented in which the IT is temporarily excised and then reinserted, followed by postoperative occlusion of the nose for at least 2 weeks. METHODS A retrospective case series of 12 patients with inverted papilloma (IP) of the maxillary sinus (Krouse II-III) and 2 patients with 3 mucoceles of the maxillary sinus after a Caldwell-Luc operation were reviewed. After a follow-up period of 12-80 months (28 months on average) all patients underwent endoscopy, and in four cases, additionally, an MRI was performed. RESULTS There was no recurrence of tumor or mucocele after 12-80 months. The IT and its important function for warming and humidifying the inhaled air could be preserved up to now in all 15 operated sides. The patients did not have any specific pain postoperatively and there was no postoperative bleeding. They all tolerated occlusion for 2-4 weeks. Two patients developed mucoceles due to the formation of scar tissue after endonasal tumor surgery. In three cases of endonasal endoscopic Denker operation patients reported some degree of numbness or irritation of the ipsilateral frontal teeth. CONCLUSION The IT can be preserved in endonasal endoscopic medial maxillectomy for treatment of IP without a higher incidence of tumor recurrence. Aftercare should specifically focus on preventing the development of mucoceles caused by scarring.
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Affiliation(s)
- Rainer K Weber
- Division of Sinus and Skull Base Surgery, Traumatology, Department of Ear, Nose, and Throat, Hospital Karlsruhe, Moltkestrasse 90, 33 Karlsruhe, Germany.
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Lombardi D, Tomenzoli D, Buttà L, Bizzoni A, Farina D, Sberze F, Karligkiotis A, Castelnuovo P, Nicolai P. Limitations and complications of endoscopic surgery for treatment for sinonasal inverted papilloma: a reassessment after 212 cases. Head Neck 2010; 33:1154-61. [PMID: 20967873 DOI: 10.1002/hed.21589] [Citation(s) in RCA: 81] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2010] [Revised: 07/14/2010] [Accepted: 07/26/2010] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND The purpose of this study was to define the optimal surgical strategy for sinonasal inverted papilloma in relation to the site of origin and tumor extent. METHODS Retrospective analysis of patients affected by inverted papilloma treated by purely endoscopic or combined approaches at the Department of Otorhinolaryngology of the University of Brescia and Pavia-Varese from November 1991 to December 2007. RESULTS Two hundred twelve patients were considered eligible for this study. An exclusive endoscopic approach was performed in 198 patients (93.4%); the remaining 14 patients (6.6%) underwent an endoscopic approach combined with an osteoplastic frontal flap. Follow-up ranged from 24 to 192 months (mean, 53.8 months). A single recurrence was observed in 12 patients (5.7%). Twenty complications (9.4%) were observed. CONCLUSION Endoscopic surgery is the first choice in the treatment of inverted papilloma; only lesions with extensive involvement of frontal sinus and/or supraorbital cell may require a combined approach. A minimum follow-up of 5 years is recommended.
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Affiliation(s)
- Davide Lombardi
- Department of Otorhinolaryngology, University of Brescia, Brescia, Italy.
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Eloy P, Mardyla N, Bertrand B, Rombaux P. Endoscopic endonasal medial maxillectomy: case series. Indian J Otolaryngol Head Neck Surg 2010; 62:252-7. [PMID: 23120722 DOI: 10.1007/s12070-010-0076-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
INTRODUCTION A medial maxillectomy (MM) consists of a complete resection of the medial wall of the maxillary sinus. Traditionally the surgery is performed via an open approach. With more familiarity and expertise in endoscopic sinus surgery the endonasal approach is feasible. OBJECTIVE To expose the surgical technique and report the results of endonasal endoscopic MM in a series of 6 consecutive patients. MATERIALS AND METHODS Between August 2006 and October 2009, 6 patients were operated with this procedure. All were men. The mean age was 62-year-old (range: 43-83). In 5 cases, the surgery was performed for inverted papillomas confined to the maxillary sinus. In one case it was a primary surgery whereas it was a revision surgery for the others. The sixth patient was operated for a solitary extramedullary plasmocytoma inserted on the intersinonasal wall persistent after an external radiation therapy. RESULTS All the patients are free of disease at the time of writing with a mean follow-up of 18,2 months (range: 9-38). This has been confirmed by a nasal endoscopy and CT scans. There were no major per or postoperative complications. Patients suffered from crusting for at least 6 months postoperatively necessitating daily nasal douches. One patient is still complaining of intermittent epiphora when he is exposed to wind. CONCLUSION Endoscopic MM can be successfully performed for the resection of expanding processes involving the maxillary sinus and/or the intersinonasal wall. Compared to open approaches, it seems to be as effective with less postoperative morbidity. An important technical point is to do the anterior osteotomy in front of the nasolacrimal duct in order to expose the prelacrimal recess that is typically an area for possible recurrence. Exact determination of the tumor attachment during the surgery is another key point for success.
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Affiliation(s)
- Ph Eloy
- Department of ENT and Head and Neck Surgery, Cliniques Universitaires de Mont-Godinne, Université Catholique de Louvain, Yvoir, Belgium
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Bilateral inverted papilloma: A report of two cases and review of the current literature. Indian J Otolaryngol Head Neck Surg 2010; 62:313-6. [PMID: 23120732 DOI: 10.1007/s12070-010-0079-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
Inverted papilloma is locally aggressive tumour which typically presents as a unilateral nasal polyp. Whilst it has a malignant potential it rarely transforms and in its benign form the main concern originates from its locally aggressive nature and substantial propensity to recur. Bilateral disease can also be due to inverted papilloma, sometimes due to direct extension of the tumour, but it can also occur as two distinct lesions. Here we report two cases of bilateral involvement, review the current literature and highlight some important issues on the management and follow-up of this well known neoplasm.
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