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Can Computed Tomography Findings Predict the Recurrence of Sinonasal Inverted Papilloma?
Eran Glikson1,2, Alberto Dragonetti3, Ethan Soudry2,4
1Department of Otolaryngology-Head and Neck Surgery, Sheba Medical Center, Tel-Hashomer, Israel.
Summary
Computed tomography (CT) can predict the attachment site of sinonasal inverted papilloma, but its accuracy does not influence long-term surgical outcomes. Tumor recurrence rates were similar regardless of CT findings.
Area of Science:
- Otolaryngology
- Neurosurgery
- Radiology
Background:
- Sinonasal inverted papilloma (SIP) is a benign but locally aggressive tumor.
- Accurate prediction of tumor attachment sites is crucial for complete surgical resection and preventing recurrence.
- Computed tomography (CT) is a key imaging modality for evaluating SIP.
Purpose of the Study:
- To assess the correlation between CT-predicted tumor attachment sites and long-term surgical outcomes in patients with sinonasal inverted papilloma.
- To determine if preoperative CT findings, specifically focal hyperostosis, predict tumor recurrence.
Main Methods:
- Retrospective cohort study involving 195 patients who underwent attachment-oriented resection of inverted papilloma.
- Analysis of preoperative CT scans to identify focal hyperostosis and its concordance with the actual tumor attachment site.
- Evaluation of tumor recurrence as the primary outcome measure.
Main Results:
- Focal hyperostosis was detected on CT in 65% of patients, often coinciding with the tumor attachment site (90%).
- The overall recurrence rate was 9.7%, with no significant correlation found between recurrence and tumor stage, surgical approach, or presence of squamous cell carcinoma.
- A significantly higher recurrence rate (38.5%) was observed when intraoperative findings of the tumor attachment site did not match the CT-identified hyperostosis location (OR, 6.5).
Conclusions:
- Preoperative CT detection of focal hyperostosis does not reliably predict the long-term surgical outcome for sinonasal inverted papilloma resection.
- While CT can indicate the tumor attachment site, discordance with intraoperative findings is associated with increased recurrence risk.
