Long-term results of endonasal sinus surgery in sinonasal papillomas.
OBJECTIVE
To assess the value of endonasal sinus surgery in the management of sinonasal papillomas.


METHODS
Retrospective study including 43 patients operated on for sinonasal papilloma in a long-term follow-up.


METHODS
In 26 cases (60%) an endonasal approach, in eight cases (19%) an external approach, and in four cases (9%) a combined procedure was performed to remove these tumors. Five septal lesions (12%) were resected under direct vision. The original sections and charts of all patients were reviewed to assess clinical data. Follow-up information was available for 42 of our patients (98%) with a mean follow-up of 62 months.


RESULTS
Histologic examination revealed 34 cases of inverted papilloma (79%), five cases of exophytic papilloma (12%), and four cases of columnar cell papilloma (9%). Malignancy occurred in 4 of 43 patients (9%), and recurrences developed in 8 of 42 patients (19%). Two of these recurrences happened after endoscopic sinus surgery (two inverted papillomas), three after lateral rhinotomy (three inverted papillomas), one after a combined procedure (one inverted papilloma), and two after simple resection (two exophytic papilloma).


CONCLUSIONS
In keeping with our experience, the endonasal endoscopic approach, often in combination with a medial maxillectomy, is favored for the treatment of sinonasal papilloma because of a lower recurrence rate and a better cosmetic result. In some larger tumors and lesions in difficult locations, better visualization can be obtained by a combined external and endonasal approach.
Kraft
Marcel
M
Department of Otorhinolaryngology-Head and Neck Surgery, University Hospital of Lausanne, Switzerland.
Simmen
Daniel
D
Kaufmann
Thomas
T
Holzmann
David
D
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004724:Endoscopy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008866:Microsurgery; D008875:Middle Aged; D009300:Nasal Septum / Q000473:pathology / Q000601:surgery; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis / Q000473:pathology / Q000601:surgery; D009666:Nose / Q000473:pathology / Q000601:surgery; D009669:Nose Neoplasms / Q000145:classification / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*; D010212:Papilloma / Q000145:classification / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*; D010255:Paranasal Sinus Neoplasms / Q000145:classification / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*; D010256:Paranasal Sinuses / Q000473:pathology / Q000601:surgery; D012086:Reoperation; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome