Inverted Papilloma of the Maxillary Sinus: A Recurrence Analysis According to Surgical Approaches

Area of Science:

• Otolaryngology
• Neurosurgery
• Surgical Oncology

Background:

• Inverted papillomas (IP) of the maxillary sinus (MS) can be surgically resected via various approaches.
• Comparing recurrence rates across different surgical modalities is crucial for optimal patient outcomes.

Purpose of the Study:

• To compare the recurrence rates of maxillary sinus inverted papillomas (IP) based on different surgical techniques.
• To evaluate the efficacy and safety of various surgical approaches for MS IP resection.

Main Methods:

• A retrospective analysis of 155 surgical cases of sinonasal IPs originating from the MS.
• Patients were categorized into three groups: endoscopic resection (ESS), ESS with Caldwell-Luc (ESS with CL), and expanded endoscopic approaches (ExEA).
• Kaplan-Meier curves were used to analyze recurrence rates and compare surgical outcomes.

Main Results:

• The overall recurrence rate was 5.8% (9/155) over a mean follow-up of 24.2 months.
• Recurrence rates were 10.0% for ESS, 3.5% for ESS with CL, and 0% for ExEA.
• ExEA demonstrated a significantly lower recurrence rate than ESS (p=0.024) and shorter postoperative hospitalization than ESS with CL (p<0.001).

Conclusions:

• Expanded endoscopic approaches (ExEA), including endoscopic medial maxillectomy and prelacrimal recess approach, are highly effective for maxillary sinus inverted papillomas.
• ExEA offers a superior alternative to traditional ESS and ESS with CL, with reduced recurrence and shorter hospital stays.