Diagnosis and Treatment of Sinonasal Inverted Papilloma: Retrospective Study

Resumen

Introduction: Sinonasal inverted papilloma (SIP) are rare benign neoplasms characterized by their locally aggressive behaviour, expansive growth, high recurrence rates and potential for malignant transformation. Endonasal endoscopic surgery is nowadays the gold-standard approach for its treatment.

Aims: Review the experience of a university tertiary hospital in the diagnosis and surgical treatment of SIP, identifying potential predictive risk factors for disease recurrence.

Material and Methods: Observational, retrospective and descriptive study; literature revision.

Results: The study included 14 patients with a median age of 51,1±17,5 years and a slight predominance of males (64,3%). According to Krouse classification, 10 tumours were classified as stage II (71,4%) and 4 as stage III (28,6%). Eighteen procedures were performed (14 primaries; 4 revisions), including 11 exclusively-endoscopic approaches (61,1%) and 7 combined approaches (38,9%). Global recurrence rate was 28,6% and mean time to recurrence was 65±22 months. Bivariate analysis of potential risk factors for recurrence didn’t find any association with gender (p=0.095), age (p=0.066), Krouse stage (p=0,520) or surgical approach (p=1,000).

Conclusion: Endonasal endoscopic surgery allows for effective resections in selected tumours, with minimal morbidity and respecting oncologic safety principles. Our experience highlights the importance of endoscopic and imaging life-long surveillance during the post-operative follow-up period of SIN, in order to timely diagnose and treat recurrences and even malignant transformations.