Sinonasal Inverted Papilloma: Risk factors for recurrence
Keywords:
Inverted Papilloma; Endoscopic Sinus Surgery; Recurrence; Risk FactorsAbstract
Aims: Clinical characterization of patients diagnosed with inverted sinonasal papilloma (IP) and identification of predictive factors of recurrence.
Study design: Retrospective study.
Material and Methods: Clinical chart review of IP who underwent surgical treatment between 2003 and 2017.
Results: Twenty-two cases with a mean age of 58 ± 12 years, predominantly male (64%), were included. Krouse II and III stages were the most common and accounted for 54.5% and 31.8% of patients, respectively. Most patients (95.5%) were treated by an exclusively endoscopic approach and we found an overall recurrence rate of 37.5%. There was a trend towards a higher recurrence rate in patients with advanced stages (57.1% vs. 20%, p=0.27). Frontal sinus extension was the only independent predictive factor for recurrence (OR=8.7, p=0.045).
Conclusion: Surgical treatment should be planned according to the location and extent of the tumor. For tumors in the early stages, endoscopic approach is the treatment of choice. For tumors in advanced stages and/or for those with extension to the frontal sinus, association of an external approach should be considered, whenever the location of the lesion does not allow complete endoscopic control. Prolonged follow-up is recommended, as recurrence can be late and there is a risk of malignant transformation.
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