DIAGNOSIS AND TREATMENT OF PATIENTS WITH SINONASAL INVERTED PAPILLOMA

Georgian Med News. 2020 Sep:(306):31-37.

Abstract

The frequency of occurrence of inverted papilloma (IP) ranges from 0.4% to 7% of all neoplasms of the nasal cavity and paranasal sinuses. Inverted papilloma is a benign epithelial tumor that refers to Schneider's sinonasal papilloma. IP is usually diagnosed in the late stages in average, 1-4 years after the first appearance of sinonasal symptoms. The purpose of this study - to summarize the results of diagnosis and treatment of patients with sinonasal inverted papilloma, who underwent surgical treatment in our department. We evaluated 37 patients with histologically verified sinonasal IP from 2015 to 2019. 29 were men (78,4%), and 8 women (21,6%). Along with generally accepted clinical studies, all patients underwent CT and MRI of the paranasal sinuses. Using the results of CT and MRI images, all patients were classified according to the Krouse classification. We evaluated the postoperative period, the presence of complications. The main criteria for assessing the results of treatment were indicators of continued growth and recurrence of IP. Endonasal endoscopic approach was used in the surgical treatment of patients. IP occurred more common in the maxillary sinus - in 16 (43.2%) patients and in the ethmoid - in 15 (40.5%). In the frontal sinus or frontoethmoidal recess - in 5 (13.5%) of the examined patients. In one case (2.7%), the inverted papilloma originated from the sphenoid sinus. Based on the Krouse classification of IP, the following results were obtained: T1 stage was detected in 5 (13.5%) patients, T2 in 22 (59.5%), T3 in 7 (18.9%), T4 - in 3 (8.1%) examined patients. We have used endoscopic endonasal approach in its various options for the treatment of patients. Based on postoperative CT and MRI scans, continued growth was determined in 3 (8.1%) patients, while the average term for detecting was 4 months. IP recurrence was diagnosed in 7 (18.9%) patients, with an average time of recurrence 14 months. CT and MRI are mandatory examination methods in patients with inverted papilloma. Inverted papilloma most common was diagnosed at T2-T3 stages and found in the maxillary and ethmoid sinus. Recurrence of IP was diagnosed in 7 (18.9%) patients, with an average recurrent rate in 14 months. Surgical treatment with removal area of hyperostosis and laser destruction surrounding tissues is the method of choice.

MeSH terms

  • Endoscopy
  • Female
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Maxillary Sinus
  • Neoplasm Recurrence, Local / surgery
  • Papilloma, Inverted* / diagnostic imaging
  • Papilloma, Inverted* / surgery
  • Paranasal Sinus Neoplasms* / diagnostic imaging
  • Paranasal Sinus Neoplasms* / surgery
  • Retrospective Studies