Introduction: Inverted papilloma is benign epidermal neoplasm of not recognized etiology. The lesion is estimated to represent 0.5-4% of sinonasal tumors. Generally inverted papilloma is unilateral, arises from the lateral nasal wall and characterizes with local destruction and rapid growth. The tumor can possibly undergo malignant transformation. The treatment of choice is surgery, recently endoscopic approach is considered to be superior to the open approach. The aim of study: was evaluation of recurrent inverted papilloma treatment results in the experience of Otolaryngology Department, Medical University of Warsaw, from 1982 to 2009. Material: The group of 124 patient (66 men and 58 women) aged from 26 to 79 with inverted papilloma operated between 1982 and 2009 were enrolled in the study. Follow up was from 6 months to 27 years. Results: Most common primary localization of the tumor was combined lateral nasal wall and maxillary sinus (42%). In 37% the lesion involved unilaterally the lateral nasal wall, maxillary sinus and ethmoid sinuses, rarely it was localized only in the lateral nasal wall (16.1%) and exclusively in the nasal septum (4.8%). All the patients were treated surgically, 46% of patients underwent endoscopic procedure, 37.1% lateral rhinotomy, 15% Denker rhinotomy and 1.6% midfacial degloving. Recurrence was observed in 15.3% including 57.9% after endoscopic surgery, 26% after Denker operation and 15.8% after lateral rhinotomy. Malignant transformation was observed in 5 patient (4%). All the patients with recurrent inverted papilloma were treated surgically, 5.3% of patient underwent midfacial degloving, 5.3% Caldwell- Luc operation, 10.5% endoscopic procedure, 26.3% Denker operation and 52.6% lateral rhinotomy. Conclusions: 1. Endonasal and open approach should be considered in the surgical treatment of recurrent inverted papilloma. 2. Endoscopic approach is preferred in the recent years but qualifi cation for each method should depend on lesion localization, extent and volume. 3. Regular follow-up enables early recurrence diagnosis and treatment.
Inverted papilloma is a locally aggressive lesion most commonly originating from the maxillary sinus. Currently transnasal endoscopic excision is a treatment of choice in the majority of cases. The article presents the evolution of endoscopic approaches and possibilities of minimally invasive treatment in regard to tumor location.
In recent years, the incidence of sinonasal inverted papilloma (IP) in a stable population has increased significantly. The aim of the study was to analyze the occurrence of IP between the years 2002-2012 in relation to epidemiological factors in an unalterable area. Moreover, we wanted to start a discussion about the difficulties in determining the inci¬dence of benign lesions that are not included in registers. This retrospective study included a group of 69 patients who were treated in the Department of Otolaryngology, ENT Oncology, Poznań University of Medical Sciences. In 2006, we noticed a sudden change in referrals. We compared two groups of patients who were referred during two differ¬ent time periods: 11 patients (2002-2006) and 58 patients (2007-2012). Despite a marked difference in the number of patients, there were no differences between the groups in tumor location (p>0.05), stage (p=0.16), duration of symp¬toms (p=0.39), place of residence, and smoking (p=0.41). The patient`s age was the only variable that differed significantly between the groups (48.45 vs. 56.93 years; p=0.043569, respectively).
Background: Unilateral sinus disease (USD) occurs in 23 % of all cases. It is believed that it is mainly associated with cancer development. Retrospective data from large rhinological centers show that the most common USD is chronic rhinosinusitis (CRS), followed by mycosis, inverted papilloma and finally cancer, but only in a small percent of cases. The aim of the study: The analysis of USD in the group of patients who underwent FESS at the secondary referral center. Material and Method: The retrospective study of patients treated for USD in the Department of Otolaryngology in the Provincial Hospital in Poznan between June 2014 and June 2016. The analysis includes age, sex, the localization of lesions, histopathological and microbiological results, an extension of the surgery and treatment results. Results: Over the analyzed period of time, 415 FESS for chronic sinusitis were performed. In this group, 83 patients underwent surgery for USD. There were 35 women and 48 men.CRS was found in 48 cases, mycosis in nine cases, 12 patients were operated for non-malignant tumors, such as inverted papilloma (9), osteoma (2) and fibrosis tumor(1); seven patients had a choanal polyp and two of them had a foreign body in maxillary sinus – a tooth root lying loose. Four patients were diagnosed with a hypoplastic maxillary sinus and one patient suffered from frontal sinus pyocele. One side endoscopic opening of all sinuses was performed in the group with CRS, endoscopic medial maxillectomy was conducted in patients with inverted papilloma, and an isolated opening of the affected sinus was performed in the cases with mycosis. Conclusions: USD must be always suspected of malignant degeneration until proven otherwise. Endoscopic sinus surgery with the use of angled scope allows for the removal of even very extensive lesions. In our opinion, the extent of operation is determined by the nature of pathology. While extensive surgery is recommended in patients with inverted papilloma, a limited procedure should be performed in those with isolated mycosis.
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