Inverted papilloma: report of 89 cases.
OBJECTIVE
In this study, the surgical management of an inverted papilloma of the nose and paranasal sinuses performed at our institution is reviewed.


METHODS
Eighty-nine patients diagnosed with an inverted papilloma and treated at the Ear, Nose, and Throat Department of Bologna University from January 1980 to January 2001 were retrospectively reviewed. Only 86 out of the 89 patients were retrospectively analyzed because 3 patients were treated for malignant tumors because of the association between inverted papilloma and invasive squamous cell carcinoma. Fifty patients were treated using traditional techniques such as lateral rhinotomy and midface degloving with medial maxillectomy (11 cases), a Caldwell-Luc procedure (21 cases), and transnasal ethmoidectomy or sphenoethmoidectomy (18 cases), whereas 36 patients were treated using an endonasal endoscopic approach for their primary tumor.


RESULTS
The traditionally treated patients had a mean follow-up of 8 years (6-19 years), whereas the endoscopically treated patients had a mean follow-up of 54 months (24-97 months). The overall recurrence rate was 15%. There were 12 recurrences (24%) in the traditionally treated patients: 1 out of 11 patients (9%) had a recurrence after a medial maxillectomy by means of a lateral rhinotomy/midface degloving, whereas 11 patients out of 39 (28%) had a recurrence after more conservative procedures such as the transantral approach and transnasal ethmoidectomy or sphenoethmoidectomy. On the other hand, 1 recurrence was observed in the endoscopically treated patients (3%).


CONCLUSIONS
Traditional techniques such as Caldwell-Luc and conservative transnasal ethmoidectomy or sphenoethmoidectomy are associated with a high rate of recurrence in the treatment of an inverted papilloma. On the other hand, the endoscopic endonasal approach is an effective treatment for an inverted papilloma in selected cases and, when performed by a skilled surgeon, can achieve a radical resection of the tumor because of excellent magnification and visualization, with results comparable to those of traditional techniques such as lateral rhinotomy with medial maxillectomy.
Pasquini
Ernesto
E
Department of Otolaryngology, University of Bologna, Sant'Orsola-Malpighi Hospital, Italy. epasquini@yahoo.com
Sciarretta
Vittorio
V
Farneti
Giovanni
G
Modugno
Giovanni Carlo
GC
Ceroni
A Rinaldi
AR
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009669:Nose Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery*; D010212:Papilloma / Q000000981:diagnostic imaging / Q000601:surgery*; D010255:Paranasal Sinus Neoplasms / Q000601:surgery*; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed