A Study on 28 Cases with Sinonasal Inverted Papilloma

Abstract

We investigated the data of 28 patients (23 men and 5 women) with sinonasal inverted papilloma who were treated at our hospital between January 2002 and December 2015. The average age of the patients was 60.1 (range, 38–77 yo). The most common presenting symptom, unilateral nasal obstruction, was seen in 75% of cases. Of the 28 patients, one case had inverted papilloma accompanied by squamous cell carcinoma. The tumors were classified by the Krouse staging system based on the findings in computed tomographic (CT) images, as follows; T1, 3 cases; T2, 16 cases; T3, 6 cases; T4, 2 cases (1 case with no data on the imaging findings was excluded). Preoperative magnetic resonance imaging (MRI) was performed in 8 patients, and we considered that the MRI was useful to evaluate the tumor extent. According to the result of preoperative biopsy or intraoperative rapid diagnosis, 15 cases were diagnosed as having inverted papilloma before or during surgery. All patients were treated by surgery. Endoscopic sinus surgery (ESS) was mainly performed for the T1 and T2 cases, while ESS combined with other procedures was performed for the T3 and T4 cases. Postoperative recurrence occurred in 8 cases (29.6%).

In conclusion, preoperative biopsy or intraoperative rapid diagnosis, preoperative imaging studies, and adequate tumor removal by the best surgical approach are important to avoid recurrence of the tumor.