A Retrospective Observational Study of 18 Cases of Sinonasal Inverted Papilloma Treated with Surgical Management

• Published in: Nihon Bika Gakkai Kaishi (Japanese Journal of Rhinology) Vol. 60; no. 2; pp. 146 - 153
• Main Authors: Sato, Ryosuke, Wada, Tetsuji, Harabuchi, Yasuaki
• Format: Journal Article
• Language: Japanese
• Published: Japan Rhinologic Society 2021
• Subjects: Imaging findings; Malignancy; Sinonasal inverted papilloma; Site of attachment
• ISSN: 0910-9153; 1883-7077
• DOI: 10.7248/jjrhi.60.146

Eighteen cases of sinonasal inverted papilloma treated with surgery from July 2011 to July 2020 were retrospectively analyzed. Fourteen of the patients were men and 4 were women. The median age was 68 years old. In the Krouse staging system, 2 cases were assessed as T1, 4 as T2, 11 as T3, and 1 as T4. Thirteen cases were treated by endoscopic sinus surgery (ESS) alone, 4 underwent ESS combined with a Caldwell-Luc operation, and 1 received ESS combined with an external approach to the frontal sinus. The concordance rates of preoperative findings and the actual origin of the tumor were 11% using intranasal endoscopy, 33% with computed tomography, and 69% using magnetic resonance imaging. The tumor origin was correctly determined based on all preoperative imaging findings in 16 of the 18 cases (89%). Coexistence of squamous cell carcinoma was detected in 1 case, and there was no recurrence in this case without additional treatment. One case had recurrence as squamous cell carcinoma at 8 months after surgery. Complete resection was possible because of early diagnosis. This study shows that preoperative evaluation of the tumor origin using multiple imaging findings is important in cases of sinonasal inverted papilloma. Careful postoperative follow-up is also needed to detect recurrence and malignancy at an early stage.