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Inverted Papilloma of the Maxillary Sinus: A Recurrence Analysis According to Surgical Approaches
Jin Youp Kim1,2, Su Hwan Kim3, Pilkeun Jang4
1Department of Otorhinolaryngology-Head and Neck Surgery, Ilsan Hospital, Dongguk University, Goyang 10326, Korea.
Abstract:
(1) Background: Various surgical approaches have been introduced to resect inverted papillomas (IP) stemming from the maxillary sinus (MS). This study aimed to compare the recurrence rates of IPs originating from the MS according to various surgical modalities. (2) Methods: A total of 155 surgical cases of sinonasal IPs originating from the MS were categorized into three groups according to the surgical approach adopted: endoscopic resection via middle or inferior meatus antrostomy (ESS), ESS with Caldwell−Luc approach or canine fossa trephination (ESS with CL), and expanded endoscopic approaches (ExEA) including endoscopic medial maxillectomy or a prelacrimal recess approach. A Kaplan−Meier curve was generated to examine the recurrence rates. (3) Results: The overall recurrence rate was 5.8% (9/155) with a mean follow-up period of 24.2 months. The recurrence rates for the ESS, ESS with CL, and ExEA groups were 10.0% (7/70), 3.5% (2/57), and 0% (0/28), respectively. The ExEA group had a significantly lower recurrence rate than the ESS group (p = 0.024) and there was a tendency for lower recurrence compared to the ESS within the CL group (p = 0.145). The ExEA required a shorter postoperative hospitalization period than in ESS with CL (p < 0.001). (4) Conclusions: ExEAs to the maxillary sinus such as the PLR and EMM approaches are excellent surgical options for IPs originating from the MS.
Insights
Expanded endoscopic approaches (ExEA) significantly reduce recurrence rates for maxillary sinus inverted papillomas (IP) compared to traditional endoscopic sinus surgery (ESS). ExEA also offers shorter hospital stays, making it an excellent surgical option.
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.