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Inverted papilloma: a follow-up study including primarily unacknowledged cases
C Buchwald1, L H Nielsen, P L Nielsen
1ENT Department, Gentofte University Hospital, Hellerup, Denmark.
American Journal of Otolaryngology
|July 1, 1989
Summary
Inverted papillomas (IPs) of the nose and sinuses require early diagnosis due to aggressive growth. Surgical approach impacts recurrence, with no single method proving superior across all cases.
Area of Science:
- Otolaryngology
- Pathology
- Surgical Oncology
Background:
- Inverted papillomas (IPs) of the nose and paranasal sinuses are known for aggressive growth, bone destruction, high recurrence rates, and potential malignancy.
- The precise incidence of IPs and their association with carcinoma remain incompletely understood.
Purpose of the Study:
- To determine the incidence of inverted papillomas in a defined geographic region.
- To analyze the recurrence rates associated with different surgical approaches for IPs.
- To evaluate the association between inverted papillomas and carcinoma.
Main Methods:
- Retrospective review of 42 patients diagnosed with inverted papillomas between 1975 and 1986.
- Analysis of pathology specimens from two institutes.
- Thorough patient follow-up to assess recurrence and outcomes.
Main Results:
- The incidence of inverted papillomas was determined to be 0.6 cases per 100,000 inhabitants annually.
- Two patients (4.8%) presented with concomitant carcinoma.
- Recurrence rates varied by surgical approach: lateral rhinotomy (50%), sinusectomy (62%), and endonasal excision (43%), with no statistically significant differences observed.
Conclusions:
- Surgical approach selection for inverted papillomas should be individualized based on tumor size and location.
- Limited procedures may be suitable for visible, confined lateral lesions.
- Lateral rhinotomy is necessary for extensive or less visible tumors, while septal IPs are often amenable to local excision due to early detection.