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[Inverted papilloma: endoscopic versus external surgery. Apropos of 28 cases]
O Duruisseau1, L Yona, I Wagner
1Service d'ORL et chirurgie cervico faciale, Hôpital Foch, 40, rue Worth, 92150 Suresnes, France.
Summary
Endoscopic surgery is proposed as a first-line treatment for inverted papillomas when feasible, offering comparable recurrence rates to external approaches but with fewer cosmetic issues. Functional complaints were noted after endoscopic treatment.
Area of Science:
- Otolaryngology
- Surgical Oncology
Background:
- Inverted papillomas are benign tumors that can exhibit aggressive behavior and malignant transformation.
- Surgical management is the primary treatment, with both endoscopic and external approaches utilized.
Purpose of the Study:
- To compare the efficacy and outcomes of endoscopic versus external surgical approaches for inverted papillomas.
- To evaluate recurrence rates, complications, and long-term results of different surgical techniques.
Main Methods:
- Retrospective review of 35 patients treated for inverted papillomas over 10 years.
- Comparison of 13 patients treated endoscopically versus 15 treated with external surgery (medial maxillectomy by lateral rhinotomy).
- Exclusion of 7 patients with less than 12 months of follow-up.
Main Results:
- Recurrence occurred in 4 patients (2 endoscopic, 2 external).
- Three patients were diagnosed with squamous cell carcinoma.
- Late complications included cosmetic issues and epiphora after external surgery, and functional complaints after endoscopic treatment.
Conclusions:
- Endoscopic surgery is recommended as the first-line treatment for inverted papillomas when complete tumor excision and assessment are possible, and long-term follow-up is feasible.
- External approaches, such as medial maxillectomy, remain necessary for cases with associated malignancy or when endoscopic access is limited.