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Hildenbrand T, Weber RK. [Inverted papilloma of the nose and paranasal sinuses : Diagnosis, treatment, and malignant transformation]. HNO 2024; 72:257-264. [PMID: 38214715 DOI: 10.1007/s00106-023-01406-7] [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] [Accepted: 11/28/2023] [Indexed: 01/13/2024]
Abstract
Inverted papilloma (IP) are benign tumors that show a locally aggressive behavior, a high rate of recurrence, and a potential for malignant transformation. Specific radiological signs such as hyperostosis at the origin of the IP and convoluted cerebriform patterns, as well as the typical endoscopic aspect, can lead to diagnosis and enable preoperative planning of surgical access and the extent of surgery. Endonasal endoscopic techniques are considered the gold standard and the introduction of extended surgical techniques such as the prelacrimal approach, frontal drillout, or orbital transposition facilitate complete subperiosteal resection with preservation of important physiological structures. There is a risk of synchronous and metachronous squamous cell carcinomas (IP-SCC). Research focuses on radiological criteria to differentiate benign IP from IP-SCC, genetic and epigenetic factors in the process of malignant transformation, and estimation of the risk of IP progressing to IP-SCC.
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Affiliation(s)
- Tanja Hildenbrand
- Klinik für Hals‑, Nasen- und Ohrenheilkunde, Universitätsklinikum Freiburg, Killianstr. 5, 79106, Freiburg, Deutschland.
| | - Rainer K Weber
- Sektion Nasennebenhöhlen- und Schädelbasischirurgie, Traumatologie, Klinik für Hals‑, Nasen- und Ohrenheilkunde, Städtisches Klinikum Karlsruhe, Karlsruhe, Deutschland
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2
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Pradhan P, Mishra A, Preetam C, Parida PK, Sarkar S, Samal DK, Samal S. Exclusive Endoscopic Approach in the Management of Sinonasal Inverted Papilloma. Indian J Otolaryngol Head Neck Surg 2023; 75:785-792. [PMID: 37206813 PMCID: PMC10188869 DOI: 10.1007/s12070-022-03332-6] [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: 01/30/2022] [Accepted: 11/29/2022] [Indexed: 12/23/2022] Open
Abstract
Background: With the advancement in endoscopic endonasal surgeries, there has been a change in the surgical approach from the traditional open surgeries to the more conservative endoscopic endonasal approach for the management of sinonasal inverted papilloma. In the present study, we have shared our experience of endoscopic excision inverted papilloma involving the paranasal sinuses in a tertiary care hospital. Materials and methods: It is a retrospective case series of 28 patients who underwent endoscopic excision of inverted papilloma of paranasal sinus in a tertiary care hospital from April 2017 to October 2020. The medical records were retrospectively analyzed for the clinical, radiological, pathological, intraoperative and postoperative findings and later compared among the surgical approaches. Results: Of the total of 28 patients with inverted papilloma (3; Krouse 2 and 25; Krouse 3), 11(21.4%) patients were operated through endoscopic modified Denker, 8(39.3%) patients with endoscopic medial maxillectomy and 6(21.4%) patients with endoscopic sinus surgery. Patients who underwent modified endoscopic approach had lesser complications compared to the standard endoscopic procedures. Conclusion: Endoscopic excision of the sinonasal inverted papilloma can be a valid alternative to the open surgical approach, enabling complete clearance of the disease with a minimal complication rate. A large population with a long-term follow-up may be needed for a better understanding of the results. Supplementary Information The online version contains supplementary material available at 10.1007/s12070-022-03332-6.
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Affiliation(s)
- Pradeep Pradhan
- Department of ENT and Head Neck Surgery, AIIMS, Bhubaneswar, Odisha 751019 India
| | - Abhijeet Mishra
- Department of ENT and Head Neck Surgery, AIIMS, Bhubaneswar, Odisha 751019 India
| | - C. Preetam
- Department of ENT and Head Neck Surgery, AIIMS, Bhubaneswar, Odisha 751019 India
| | | | - Saurav Sarkar
- Department of ENT and Head Neck Surgery, AIIMS, Bhubaneswar, Odisha 751019 India
| | - Dillip Kumar Samal
- Department of ENT and Head Neck Surgery, AIIMS, Bhubaneswar, Odisha 751019 India
| | - Swagatika Samal
- Department of Pathology and Laboratory Medicine, AIIMS, Bhubaneswar, Odisha 751019 India
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3
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Imaging After Sinonasal Surgery. Neuroimaging Clin N Am 2021; 32:55-73. [PMID: 34809844 DOI: 10.1016/j.nic.2021.08.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Posttreatment imaging evaluation of sinuses encompasses a wide gamut of procedures, ranging from endoscopic procedures for sinonasal inflammatory diseases to markedly radical surgeries for malignant neoplasms (with or without reconstructions), as well as providing access for surgeries involving the anterior and central skull base. Advances in both techniques and devices have expanded the use of endoscopic approaches in managing both benign and malignant lesions, in addition to being the primary surgical method for treating all medically refractive sinonasal inflammatory disorders. Familiarity with the complex anatomy in the sinonasal region and knowledge of the various procedures is indispensable in interpreting these imaging studies.
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Endoscopic Modified Medial Maxillectomy for Inverted Papilloma of the Maxillary Sinus. J Craniofac Surg 2021; 33:e71-e73. [PMID: 34261968 DOI: 10.1097/scs.0000000000007989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Sinonasal inverted papilloma (SNIP) is a benign tumor that can be surgically managed by an endoscopic approach. However, SNIP has a high recurrence rate, mainly due to incomplete resection. AIM This study aimed to analyze the outcomes of endoscopic modified medial maxillectomy in treating SINP originating from the maxillary sinus. METHODS The authors retrospectively analyzed 24 patients treated for SNIP via endoscopic modified medial maxillectomy at our institution between August 2014 and June 2019. During surgery, the mucosa involved in the tumor was stripped, and the bone underlying the tumor base was completely excised. Demographic data, surgical technique, location of SNIP attachment, complications, follow-up duration, and recurrence were recorded. RESULTS Twenty four patients with SNIP were identified (16 males). All patients had Krouse stage-III disease. Eleven patients presented with single attachment and 13 with multiple attachments. None of the patients had any complications during surgery. Four patients had postsurgical facial numbness around the cheek and upper lip. After a mean follow-up of 35.12 ± 14.98 months, no recurrence of SNIP was observed. CONCLUSIONS AND SIGNIFICANCE Endoscopic modified medial maxillectomy is a safe and effective technique for treating SNIP. Recurrence can be reduced by complete excision of the attachment sites.
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Endoscopic maxillectomy: anatomo-radiological description of the "double" maxillary sinus window. Eur Arch Otorhinolaryngol 2021; 278:3813-3820. [PMID: 33481079 DOI: 10.1007/s00405-021-06604-z] [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: 12/01/2020] [Accepted: 01/05/2021] [Indexed: 10/22/2022]
Abstract
OBJECTIVES/HYPOTHESIS To present a modified endoscopic medial maxillectomy (MEMM) approach to control maxillary sinus pathologies. METHODS MEMM was completed in 13 fresh-frozen specimens. An MEMM includes cutting the nasolacrimal duct, inferior meatus flap, and repositioning the inferior turbinate (IT). The following measurements were obtained: length of IT, height from the nasal floor to valve of Hasner, height of the IT at the level of valve of Hasner, height of the IT at the insertion of the middle turbinate, and distance from the piriform aperture to the posterior wall of maxillary sinus and to the posterior border of palatine bone. Similar measurements were also performed on craniofacial computed tomography (CT) scans (n = 50). The surgical technique was performed in a case series (n = 8). RESULTS The mean of the specimens was 82 (range 70-95) years old. The average area of the harvested inferior meatus flap area was 9.6 ± 1.0 cm2. In the radiologic study, the mean maximum antrostomy area was 8.8 ± 1.7 cm2 and the IT area overlapping the antral window was 5.8 ± 1.1 cm2, the area allowing a double window control was 3.1 ± 1.9 cm2, the posterior IT insertion length was 0.7 ± 0.4 cm, and the inferior meatus flap covering the inferior meatotomy had an area measuring 6.7 ± 1.7 cm2. Eight patients underwent MEMM for various benign conditions showing no recurrence after 26 month follow-up. CONCLUSION The proposed modifications of MEMM provide a "double" window maxillary sinus control with access to all maxillary walls and preservation of the IT.
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Abstract
Unilateral diseases of the maxillary sinus are among the most common rhinologic diagnoses. The diversity of these diseases can represent a challenge for the treating physician. The spectrum ranges from harmless maxillary sinus cysts that seldom require treatment, to highly aggressive malignant tumors. Special attention should be given to the management of inverted papilloma. These benign tumors are characterized by high recurrence rates and the potential for malignant transformation. The key to minimizing recurrence is precise surgical intervention. Other unilateral maxillary sinus diseases such as the antrochoanal polyp and the fungus ball (aspergilloma) are also discussed in depth.
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Affiliation(s)
- E Giotakis
- Erste HNO-Universitätsklinik Athen, Hippokrateio-Krankenhaus, Athen, Griechenland.
| | - S Knipping
- Klinik für Hals‑, Nasen- und Ohrenheilkunde, Kopf- und Halschirurgie, Plastische Operationen, Städtisches Klinikum Dessau und Martin-Luther-Universität Halle-Wittenberg, Dessau, Deutschland
| | - T Kühnel
- Klinik und Poliklinik für Hals-Nasen-Ohren-Heilkunde, Universität Regensburg, Regensburg, Deutschland
| | - R K Weber
- HNO-Klinik, Städtisches Klinikum Karlsruhe, Karlsruhe, Deutschland.,Sinus Academy, Karlsruhe, Deutschland
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7
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Lee JT, Yoo F, Wang M, Vengerovich G, Suh JD. Modified endoscopic Denker approach in management of inverted papilloma of the anterior maxillary sinus. Int Forum Allergy Rhinol 2020; 10:533-538. [PMID: 32104956 DOI: 10.1002/alr.22513] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Revised: 09/09/2019] [Accepted: 10/16/2019] [Indexed: 12/29/2022]
Abstract
BACKGROUND Inverted papilloma (IP) is a benign epithelial tumor of the sinonasal cavity that is locally aggressive and has a propensity for recurrence. Tumors involving the anterior maxillary sinus can be challenging to reach endoscopically, and have historically been approached through a Caldwell-Luc or canine fossa trephination. We present a case series of 22 patients with maxillary IPs originating from the anterior wall, which were successfully resected using a modified endoscopic Denker (MED) procedure. This technique enables access to the entire maxillary sinus without the need for a separate transseptal or sublabial incision. METHODS A retrospective chart review was performed on patients who underwent the MED approach for management of maxillary IPs involving the anterior wall from 2012 to 2018. The demographic data, clinical presentation, radiographic findings, pathology, and surgical outcomes were reviewed. RESULTS Twenty-two patients were identified, including 13 males and 9 females. Eighteen of the 22 patients had prior surgery and all had Krouse stage 3 disease. After a mean follow-up of 24 (range, 4-63) months, only 1 patient (4.5%) developed a recurrence, which was treated successfully with endoscopic resection. Complications included 1 patient with preoperative epiphora who required dacryocystorhinostomy, epistaxis in another, and 1 patient with transient upper lip numbness. No patients developed alar notching or pyriform aperture stenosis. CONCLUSION The MED technique is highly effective for surgical resection of primary and recurrent maxillary IPs involving the anterior wall, providing complete access to the entire maxillary sinus. In many cases, the MED can obviate the need for an adjunctive sublabial or transseptal incision, while also providing excellent exposure for postoperative surveillance.
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Affiliation(s)
- Jivianne T Lee
- Department of Head and Neck Surgery, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA
| | - Frederick Yoo
- Department of Head and Neck Surgery, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA
| | - Marilene Wang
- Department of Head and Neck Surgery, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA
| | - Gennadiy Vengerovich
- Department of Head and Neck Surgery, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA
| | - Jeffrey D Suh
- Department of Head and Neck Surgery, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA
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Saibene AM, Felisati G, Pipolo C, Bulfamante AM, Quadrio M, Covello V. Partial Preservation of the Inferior Turbinate in Endoscopic Medial Maxillectomy: A Computational Fluid Dynamics Study. Am J Rhinol Allergy 2020; 34:409-416. [PMID: 31992048 DOI: 10.1177/1945892420902005] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Background Endoscopic medial maxillectomy (EMM) is a workhorse for multiple sinonasal conditions. To reduce its burden on the sinonasal physiology, several modified EMM (M-EMM) have been proposed. Objective: In order to provide a theoretical basis for EMM and its modifications, this study introduces a computational fluid dynamics (CFD) model, based on a time-resolved direct numerical simulation, describing EMM and assessing the role of the M-EMM in preserving the overall fluid dynamics of the sinonasal cavities. Methods A normal sinonasal CT scan was converted into a geometrical model and used as a reference; 2 anatomies were then created by virtual surgery, mimicking EMM and M-EMM, with the latter sparing the anterior portion of inferior turbinate and medial maxillary sinus wall. The airflow was simulated in the models via the OpenFOAM CFD software and compared in terms of flow rate, mean and fluctuating velocity, vorticity, and turbulent structures. Results The analysis shows that EMM induces a massive flow rate increase in the operated side, which becomes less obvious in the M-EMM model. In contrast to M-EMM, EMM induces higher velocity fields that reach the maxillary sinus. Velocity and vorticity fluctuations are negligible in the baseline model, but become increasingly evident and widespread in the M-EMM and EMM models. Conclusions A significant disruption of the nasal fluid dynamics is observed in EMM, while M-EMM minimizes variations and reduces interference with nasal air conditioning. Our analysis provides insights into the pathophysiology of radical sinus surgery and provides a theoretical basis for the ability of M-EMM to reduce the temporary surgery-related changes on both healthy and operated sides.
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Affiliation(s)
- Alberto M Saibene
- Unit of Otolaryngology, ASST Santi Paolo e Carlo, Milan, Italy.,Department of Health Sciences, Università degli Studi di Milano, Milan, Italy
| | - Giovanni Felisati
- Unit of Otolaryngology, ASST Santi Paolo e Carlo, Milan, Italy.,Department of Health Sciences, Università degli Studi di Milano, Milan, Italy
| | - Carlotta Pipolo
- Unit of Otolaryngology, ASST Santi Paolo e Carlo, Milan, Italy.,Department of Health Sciences, Università degli Studi di Milano, Milan, Italy
| | - Antonio Mario Bulfamante
- Unit of Otolaryngology, ASST Santi Paolo e Carlo, Milan, Italy.,Department of Health Sciences, Università degli Studi di Milano, Milan, Italy
| | - Maurizio Quadrio
- Department of Aerospace Sciences and Technologies, Politecnico di Milano, Milan, Italy
| | - Vanessa Covello
- Department of Health Sciences, Università degli Studi di Milano, Milan, Italy.,Department of Aerospace Sciences and Technologies, Politecnico di Milano, Milan, Italy
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Surgery of Inverted Papilloma of the Maxillary Sinus via Translacrimal Approach-Long-Term Outcome and Literature Review. J Clin Med 2019; 8:jcm8111873. [PMID: 31694225 PMCID: PMC6912689 DOI: 10.3390/jcm8111873] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Revised: 10/21/2019] [Accepted: 11/01/2019] [Indexed: 12/19/2022] Open
Abstract
There are several differential diagnoses of unilateral sinus disease. One of these is inverted papilloma (IP) of the maxillary sinus, which is a common benign tumor with a substantial rate of malignant transformation. In general, endoscopic endonasal techniques for addressing the tumor are favored nowadays instead of classical external approaches. The aim of this retrospective study was to investigate the long-term outcome of inverted papilloma treated endoscopically via the prelacrimal approach. We reviewed 17 patients with primary or recurrent IP of the maxillary sinus that were treated via the prelacrimal endoscopic endonasal technique. After a median follow-up period of 45.9 months (3.8 years), none of the 17 included patients showed signs of recurrent disease and no serious complications were reported. Hypoesthesia of the incisors was reported by four patients and was resolved with time in one. All of the maxillary sinuses could be fully visualized with the flexible endoscope. IP is an important differential diagnosis in the clinical finding of unilateral nasal polypoid lesions. The prelacrimal approach is an effective and safe method in the treatment of IP with limited patient morbidity.
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Curragh DS, Psaltis AJ, Tan NC, Selva D. Prelacrimal approach for nasolacrimal duct excision in the management of lacrimal system tumours. Orbit 2019; 38:308-312. [PMID: 30234416 DOI: 10.1080/01676830.2018.1518464] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Accepted: 08/28/2018] [Indexed: 06/08/2023]
Abstract
Purpose: To report a case of a lacrimal sac tumour and describe a prelacrimal approach to the maxillary sinus to excise the nasolacrimal duct in its management. To our knowledge, this approach has not been adapted to remove the nasolacrimal duct for the management of pathological processes involving the nasolacrimal system. Methods: A 58-year-old female patient presented with a 6-month history of epiphora. A lacrimal sac mass was identified, and a biopsy revealed squamous cell carcinoma. Surgical excision was performed via a combined external and endoscopic prelacrimal approach. Results: A prelacrimal approach to the maxillary sinus to excise the nasolacrimal duct in combination with an external approach facilitated an en-bloc excision of the nasolacrimal apparatus. This allowed preservation on the entire inferior turbinate following reconstitution of the lateral nasal wall at the completion of the procedure. Conclusion: The endoscopic endonasal prelacrimal approach to the maxillary sinus is a useful method to approach and excise the nasolacrimal duct in the management of nasolacrimal pathology.
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Affiliation(s)
- David S Curragh
- a South Australian Institute of Ophthalmology, Royal Adelaide Hospital , Adelaide , Australia
| | - Alkis J Psaltis
- b Department of Surgery, Otorhinolaryngology Head and Neck Surgery, The University of Adelaide , Adelaide , Australia
| | - Neil C Tan
- b Department of Surgery, Otorhinolaryngology Head and Neck Surgery, The University of Adelaide , Adelaide , Australia
| | - Dinesh Selva
- a South Australian Institute of Ophthalmology, Royal Adelaide Hospital , Adelaide , Australia
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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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12
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Wang X, Chen X, Zheng M, Liu C, Wang C, Zhang L. The Relationships Between the Nasolacrimal Duct and the Anterior Wall of the Maxillary Sinus. Laryngoscope 2018; 129:1030-1034. [PMID: 30098051 DOI: 10.1002/lary.27420] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2018] [Revised: 06/02/2018] [Accepted: 06/07/2018] [Indexed: 11/06/2022]
Abstract
OBJECTIVES/HYPOTHESIS To examine the anatomic relationships between the lower end opening into the inferior meatus of the bony nasolacrimal duct (NLD) and the anterior wall of the maxillary sinus. STUDY DESIGN Anatomical investigation. METHODS A total of 206 individuals were recruited for detailed anatomic investigation of the lower end of the bony NLD and their relation to the anterior wall of the maxillary sinus by high-resolution computed tomography (HRCT) imaging. The observed features were classified as either a fusion type or separation type, according to the HRCT images. Additionally, the angle between the anterior and medial wall of the maxillary sinus was classified as either an anterior mode or lateral mode. RESULTS The NLD anatomical fusion type was found in 40.05% and the separation type in 59.95% of the HRCT imaging scans available. The anterior mode of angle between the anterior and medial wall of the maxillary sinus was present in 64.1% of the images, and the lateral mode in 35.9% of the images. In 165 cases of anatomical fusion, the anterior mode of angle was present in 15.8% and the lateral mode in 84.2% of cases. In 247 cases of anatomical separation, the anterior mode was present in 97.2% and the lateral mode in 2.8% of cases. CONCLUSIONS The surgical anatomy of the lower end of the bony NLD and anterior wall of the maxillary sinus displays varied relationships. Preoperative use of HRCT and an awareness of the particular type of anatomical feature present are likely to aid in planning and performing successful endoscopic medial maxillectomy. LEVEL OF EVIDENCE 4 Laryngoscope, 129:1030-1034, 2019.
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Affiliation(s)
- Xiangdong Wang
- Department of Otolaryngology-Head and Neck Surgery, Beijing TongRen Hospital, Capital Medical University, Beijing, China.,Beijing Key Laboratory of Nasal Diseases, Beijing Institute of Otolaryngology, Beijing, China
| | - Xinjun Chen
- Department of Otolaryngology-Head and Neck Surgery, Beijing Mentougou Hospital, Beijing, China
| | - Ming Zheng
- Department of Otolaryngology-Head and Neck Surgery, Beijing TongRen Hospital, Capital Medical University, Beijing, China
| | - Chengyao Liu
- Department of Otolaryngology-Head and Neck Surgery, Beijing TongRen Hospital, Capital Medical University, Beijing, China
| | - Chengshuo Wang
- Department of Otolaryngology-Head and Neck Surgery, Beijing TongRen Hospital, Capital Medical University, Beijing, China
| | - Luo Zhang
- Department of Otolaryngology-Head and Neck Surgery, Beijing TongRen Hospital, Capital Medical University, Beijing, China.,Beijing Key Laboratory of Nasal Diseases, Beijing Institute of Otolaryngology, Beijing, China
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13
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Bugter O, Monserez DA, van Zijl FVWJ, Baatenburg de Jong RJ, Hardillo JA. Surgical management of inverted papilloma; a single-center analysis of 247 patients with long follow-up. J Otolaryngol Head Neck Surg 2017; 46:67. [PMID: 29262865 PMCID: PMC5738878 DOI: 10.1186/s40463-017-0246-7] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2017] [Accepted: 12/06/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Our aim was to review our management of inverted papilloma (IP), perform a recurrence analysis, and review the literature. METHODS A retrospective analysis of 247 patients treated for an IP. Patients were grouped according to surgical approach, tumor presentation (primary, residual and recurrence) and Krouse-stage. RESULTS Recurrence was observed in 20.3%, 28.6% and 35.1% (p = 0.017) of the patients who underwent endoscopic, external and combined surgery, respectively. Recurrences occurred more often in residual than primary IP (36.9% vs. 22.3%, p = 0.021). Primary endoscopic surgery had a recurrence rate of 12.5%, which was comparable to the recent literature (11.2%, 161/1433). CONCLUSIONS The relatively high number of recurrences in this cohort is explained by the long follow-up and previous (incomplete) surgery in 61.5% of the cases. The inferior outcome of residual IP underscores the importance of having a low threshold for preoperative biopsy in unilateral and atypical sinonasal disease.
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Affiliation(s)
- Oisín Bugter
- Department of Otorhinolaryngology and Head and Neck Surgery, Erasmus MC, 's-Gravendijkwal 230, 3015 CE,, Rotterdam, The Netherlands.
| | - Dominiek André Monserez
- Department of Otorhinolaryngology and Head and Neck Surgery, Erasmus MC, 's-Gravendijkwal 230, 3015 CE,, Rotterdam, The Netherlands
| | | | - Robert Jan Baatenburg de Jong
- Department of Otorhinolaryngology and Head and Neck Surgery, Erasmus MC, 's-Gravendijkwal 230, 3015 CE,, Rotterdam, The Netherlands
| | - Jose Angelito Hardillo
- Department of Otorhinolaryngology and Head and Neck Surgery, Erasmus MC, 's-Gravendijkwal 230, 3015 CE,, Rotterdam, The Netherlands
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14
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Sun Q, An L, Zheng J, Zhu D. Advances in recurrence and malignant transformation of sinonasal inverted papillomas. Oncol Lett 2017; 13:4585-4592. [PMID: 28599459 DOI: 10.3892/ol.2017.6089] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2016] [Accepted: 01/26/2017] [Indexed: 01/06/2023] Open
Abstract
Sinonasal inverted papilloma (SIP) is a benign tumor of the nasal cavity and sinus. SIP is characterized by aggressive malignant transformation and a high rate of recurrence. Inadequate removal of the tumor during surgery is one of the most significant contributors to SIP recurrence. A growing body of evidence suggests that molecular alteration in SIP, including human papilloma virus infections, single nucleotide polymorphisms of key genes, deregulation of signaling pathways and immunological changes, may lead to SIP occurrence and malignant transformation. However, the extent to which these molecular mechanisms contribute to SIP pathology and transformation remains unclear due to limited research. Further studies are warranted to elucidate the primary dependent factors that contribute to SIP etiology. The present article reviewed risk factors of progression and recurrence of SIP, including outdoor and industrial occupational exposure, smoking, septal deviation, SIP location, recurrent cases, stage of SIP-associated squamous cell carcinoma and choice of surgical method.
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Affiliation(s)
- Qingjia Sun
- Department of Otorhinolaryngology Head and Neck Surgery, The China-Japan Union Hospital of Jilin University, Changchun, Jilin 130033, P.R. China
| | - Lifeng An
- Department of Otorhinolaryngology Head and Neck Surgery, The China-Japan Union Hospital of Jilin University, Changchun, Jilin 130033, P.R. China
| | - Jun Zheng
- Department of Otorhinolaryngology Head and Neck Surgery, The China-Japan Union Hospital of Jilin University, Changchun, Jilin 130033, P.R. China
| | - Dongdong Zhu
- Department of Otorhinolaryngology Head and Neck Surgery, The China-Japan Union Hospital of Jilin University, Changchun, Jilin 130033, P.R. China
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15
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"TuNa-saving" endoscopic medial maxillectomy: a surgical technique for maxillary inverted papilloma. Eur Arch Otorhinolaryngol 2017; 274:2785-2791. [PMID: 28374054 DOI: 10.1007/s00405-017-4549-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2016] [Accepted: 03/21/2017] [Indexed: 12/18/2022]
Abstract
The maxillary sinus is the most common site of sinonasal inverted papilloma. Endoscopic sinus surgery, in particular endoscopic medial maxillectomy, is currently the gold standard for treatment of maxillary sinus papilloma. Although a common technique, complications such as stenosis of the lacrimal pathway and consequent development of epiphora are still possible. To avoid these problems, we propose a modification of this surgical technique that preserves the head of the inferior turbinate and the nasolacrimal duct. A retrospective analysis was performed on patients treated for maxillary inverted papilloma in three tertiary medical centres between 2006 and 2014. Pedicle-oriented endoscopic surgery principles were applied and, in select cases where the tumour pedicle was located on the anterior wall, a modified endoscopic medial maxillectomy was carried out as described in this paper. From 2006 to 2014 a total of 84 patients were treated. A standard endoscopic medial maxillectomy was performed in 55 patients (65.4%), while the remaining 29 (34.6%) had a modified technique performed. Three recurrences (3/84; 3.6%) were observed after a minimum follow-up of 24 months. A new surgical approach for select cases of maxillary sinus inverted papilloma is proposed in this paper. In this technique, the endoscopic medial maxillectomy was performed while preserving the head of the inferior turbinate and the nasolacrimal duct ("TuNa-saving"). This technique allowed for good visualization of the maxillary sinus, good oncological control and a reduction in the rate of complications.
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Suzuki M, Nakamura Y, Yokota M, Ozaki S, Murakami S. Modified transnasal endoscopic medial maxillectomy through prelacrimal duct approach. Laryngoscope 2017; 127:2205-2209. [PMID: 28295338 DOI: 10.1002/lary.26529] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2016] [Revised: 01/04/2017] [Accepted: 01/17/2017] [Indexed: 11/07/2022]
Abstract
OBJECTIVE We previously reported a modified endoscopic medial maxillectomy (modified transnasal endoscopic medial maxillectomy through prelacrimal duct approach [MTEMMPDA]) to resect inverted papilloma (IP), for which the inferior turbinate (IT) and nasolacrimal duct (ND) can be preserved. MTEMMPDA is a safe and effective method to obtain wide, straight access to the maxillary sinus (MS). However, there are few reported cases of patients who underwent MTEMMPDA, and even fewer of patients who underwent partial osteotomy of the apertura piriformis and the anterior wall of the MS. In this study, we analyzed the outcomes of 51 patients who underwent MTEMMPDA. STUDY DESIGN Retrospective review. METHODS All patients who underwent MTEMMPDA at our hospital between January 2004 and December 2015 were included in this study. RESULTS Fifty-one patients with sinonasal IP in the MS underwent MTEMMPDA. Recurrence was seen in the MS of one patient (follow-up of 2-138 months). The IT remained unchanged in all 51 patients without atrophy. We have not observed epiphora, eye discharge, dry nose, or persistent crusting after this surgery. Although seven patients had numbness around the upper lip after surgery, this had disappeared by 1 year after surgery. Additional partial osteotomy of the apertura piriformis and the anterior wall of the MS were done in eight patients. Deformation of the external nose was not seen. CONCLUSION This approach appears to be a safe and effective method to resect IP in the MS, even if there is additional partial osteotomy of the apertura piriformis and the anterior wall of the MS. LEVEL OF EVIDENCE 4. Laryngoscope, 127:2205-2209, 2017.
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Affiliation(s)
- Motohiko Suzuki
- Department of Otorhinolaryngology, Graduate School of Medical Sciences, Nagoya City University, Nagoya, Japan
| | - Yoshihisa Nakamura
- Department of Otorhinolaryngology, Graduate School of Medical Sciences, Nagoya City University, Nagoya, Japan
| | - Makoto Yokota
- Department of Otorhinolaryngology, Graduate School of Medical Sciences, Nagoya City University, Nagoya, Japan
| | - Shinya Ozaki
- Department of Otorhinolaryngology, Graduate School of Medical Sciences, Nagoya City University, Nagoya, Japan
| | - Shingo Murakami
- Department of Otorhinolaryngology, Graduate School of Medical Sciences, Nagoya City University, Nagoya, Japan
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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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