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Medially originated inverted papilloma
Ta-Jen Lee1, Chi-Che Huang, Yi-Wei Chen
1Division of Rhinology, Department of Otolaryngology, Chang Gung Memorial Hospital, Chang Gung University, Kwei-Shan, Taoyuan, Taiwan.
Objectives:
The objective of this study was to determine the characteristics of medially originated inverted papilloma (MOIP) and compare them with laterally originated inverted papilloma (LOIP).
Methods:
A retrospective review of the charts for a total of 83 patients with sinonasal inverted papilloma (IP) was conducted. Tumors originating from the nasal septum or the turbinates were categorized as MOIP, whereas tumors originating from the four sinuses were categorized as LOIP.
Results:
Twenty-eight (34%) and 55 (66%) cases were categorized as MOIP and LOIP. MOIP from the middle turbinate behaved more aggressively than LOIP from the ethmoid sinus (P = 0.009), but less aggressively than LOIP from the maxillary medial wall (P < 0.05). Radical procedures were implemented in 14 patients with LOIP, but not in any patients with MOIP (P = 0.002). The recurrence rates were comparable in both groups (P = 0.472).
Conclusions:
The categorization of IP on the basis of tumor origin enabled a better surgical design and more accurate excision of the tumor. Although in some cases MOIP may behave more aggressively, radical procedures were indicated in only the late Krouse stage LOIP without compromising the recurrence rate.
Insights
Medially originated inverted papilloma (MOIP) can behave aggressively, but origin-based categorization aids surgical planning. Radical procedures were reserved for advanced laterally originated inverted papilloma (LOIP), with similar recurrence rates for both types.
Area of Science:
- Otolaryngology
- Neurosurgery
- Pathology
Background:
- Inverted papilloma (IP) is a benign neoplasm of the sinonasal tract.
- Tumor origin influences IP behavior and treatment strategies.
Purpose of the Study:
- To characterize medially originated inverted papilloma (MOIP) and compare it with laterally originated inverted papilloma (LOIP).
- To evaluate the clinical behavior and treatment outcomes based on IP origin.
Main Methods:
- Retrospective chart review of 83 sinonasal inverted papilloma (IP) patients.
- Categorization of tumors as MOIP (nasal septum/turbinates) or LOIP (sinuses).
Main Results:
- MOIP (34%) and LOIP (66%) were identified.
- MOIP from the middle turbinate showed more aggressive behavior than ethmoid LOIP (P=0.009) but less than maxillary medial wall LOIP (P<0.05).
- Radical procedures were used for LOIP (14 cases) but not MOIP (P=0.002); recurrence rates were similar (P=0.472).
Conclusions:
- Categorizing IP by tumor origin improves surgical design and tumor excision.
- While MOIP can be aggressive, radical surgery was only needed for advanced LOIP, without impacting recurrence rates.
