Clinical outcomes of endoscopic and endoscopic-assisted resection of inverted papillomas: A 15-year experience

Authors: Woodworth, Bradford A.1; Bhargave, Geeta A.1; Palmer, James N.1; Chiu, Alexander G.1; Cohen, Noam A.1; Lanza, Donald C.1; Bolger, William E.1; Kennedy, David W.1

Source: American Journal of Rhinology, Volume 21, Number 5, September-October 2007 , pp. 591-600(10)

Publisher: OceanSide Publications, Inc

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Abstract:

Background: The endoscopic resection of sinonasal inverted papillomas (IPs) has been well described. However, the majority of published reports in the literature are small case series with limited clinical follow-up. The aim of this retrospective study was to review the experience with the endoscopic and endoscopic-assisted resection of IPs at a major academic tertiary care facility and assess long-term outcomes.

Methods: A retrospective review of endoscopic and endoscopic-assisted resections of IP was performed. Charts were reviewed for standard demographic data, operative technique, adjuvant approaches, complications, and postoperative follow-up times.

Results: One hundred fourteen patients (average age, 56 years) underwent endoscopic or endoscopic-assisted resection for IPs with a mean disease-free follow-up of 40 months (7-135 months). Seventeen patients developed disease after endoscopic or endoscopic-assisted resection for a recurrence rate of 15%. Average time to recurrence was 23 months. Combined approaches were used when indicated in 34% (39/114) of patients, including adjuvant osteoplastic flap, midface degloving, trephine, or Caldwell-Luc approaches. Four patients (4%) had cerebrospinal fluid leaks that were successfully repaired endoscopically.

Conclusion: In this large series of endoscopically resected IPs with extensive clinical follow-up, recurrences occurred an average of 23 months after the procedure. This emphasizes the importance of long-term endoscopic follow-up to detect recurrences in all patients. Endoscopic or endoscopic-assisted resection of IPs is a valid technique in this series with recurrence rates comparable with open approaches.

Keywords: Endoscopic-assisted; endoscopic sinus surgery; image-guidance; intraoperative CT; inverted papilloma; inverting papilloma; recurrence; sinonasal tumor

Document Type: Research article

DOI: 10.2500/ajr.2007.21.3086

Affiliations: 1: From the Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania Health System, Philadelphia, Pennsylvania

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