Diagnostic strategy and therapeutic management of sinonasal inverted papilloma: our experience with review of literature

• Published in: The Egyptian journal of otolaryngology Vol. 38; no. 1; pp. 173 - 8
• Main Authors: Bouatay, Rachida, Farhati, Amira, Abdelali, Mabrouk, N, Naourez kolsi, Korbi, Amel El, Ferjaoui, Mehdi, Harrathi, Khaled, Koubaa, Jamel
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.12.2022; Springer; Springer Nature B.V; SpringerOpen
• Subjects: Cancer; CT imaging; Diagnostic imaging; Endonasal approach; Endoscopy; Health aspects; Inverted papilloma; Magnetic resonance imaging; Medical imaging; Medical research; Medicine; Medicine & Public Health; Medicine, Experimental; MRI; Original Article; Paranasal sinuses; Patients; Radiation therapy; Sinuses; Surgery; Tumors; Tunisia; Inverted papilloma; CT; Endonasal approach; MRI; Paranasal sinuses
• ISSN: 1012-5574; 2090-8539
• DOI: 10.1186/s43163-022-00371-2

Background The sinonasal inverted papilloma is a rare benign tumor, characterized by local aggressiveness, a high rate of recurrence after surgical resection, and the possibility of malignant transformation. The aims of this study are to analyze diagnostic strategy and therapeutic modalities and to evaluate results after surgery. Methods We report a retrospective study, including patients operated for inverted sinonasal papilloma in our department. Preoperatively, all patients were assessed by CT scan (computed tomography), 9 of them by MRI (magnetic resonance imaging). Results The average age of our patients was 52 years with a male predominance. The most common symptom was unilateral nasal obstruction. The endoscopic appearance was suggestive of inverted papilloma (IP) in 75% of cases. Thirty-two patients underwent an exclusive endonasal endoscopic surgery; one patient was operated with a combined approach. Two patients underwent external approaches. A recurrence was observed in 4 patients (11%). Conclusion Preoperative investigation for IP is essentially based on MRI, also required in case of recurrence. Histological examination of the entire tumor is crucial to rule out an associated carcinoma. The “all endoscopic” management is not always achievable for these tumors.