Enhancing Approaches to Inverted Papilloma Through Computed Tomography-Based Hyperostosis Analysis

Area of Science:

• Otolaryngology
• Head and Neck Surgery
• Medical Imaging

Background:

• Sinonasal inverted papilloma (IP) has a high postoperative recurrence rate.
• Residual tumor at the attachment site (pedicle) is the primary cause of IP recurrence.
• Tailoring surgical approaches to the tumor's attachment site is critical for reducing recurrence.

Purpose of the Study:

• To investigate the tendency of hyperostosis at IP attachment locations based on detailed anatomical sites.
• To enhance the accuracy of preoperative prediction of IP attachment sites using computed tomography (CT).
• To correlate imaging characteristics with anatomical locations for improved surgical planning.

Main Methods:

• A single-center retrospective cohort study involving 127 patients diagnosed with IP.
• Analysis of attachment distribution and hyperostosis details on CT scans.
• Correlation of hyperostosis patterns with specific anatomical locations of IP attachment.

Main Results:

• IP attachments were most frequently identified in the ethmoid (n=51) and maxillary sinuses (n=59).
• Significant hyperostosis was consistently observed at the skull base, uncinate process, infraorbital wall, posterior maxillary wall, and sphenoid sinus floor.
• Non-hyperostosis was noted in the nasal septum, supraorbital cell, anterior maxillary wall, and posterior sphenoid wall.

Conclusions:

• CT-detected hyperostosis patterns at IP attachment sites vary by anatomical location.
• Identifying hyperostosis on CT aids in predicting the IP attachment site more accurately.
• These findings support tailored surgical approaches and improved patient counseling, particularly for IP involving the maxillary sinus and skull base.