Clinical outcomes of treatment of sinonasal inverted papillomas (IPs) depending on the surgical technique and learning curve.

Abstract

Sinonasal inverted papillomas (IPs) are a major challenge for ENT specialists. In the last decades, the number of endoscopic procedures has increased, while the percentage of external or double approach procedures has decreased. The aim of this study was to evaluate long-term IP treatment outcomes according to the applied surgical method. the retrospective study included 69 patients (28 women and 41 men) treated during 2002-2012 in the Department of Otolaryngology and Laryngological Oncology of Poznań University of Medical Sciences. Of these patients, 47 were operated endoscopically, 16 received a double procedure and six received an external procedure. The recurrence rate in patients treated endoscopically was 32%, while patients treated by the external/double approach showed 64% (p = 0.03306). The recurrence rate after endoscopic surgery was 75% during 2002-2006, but was 28% during 2007-2012. There was no correlation between recurrence rate and age (p = 0.087686), gender (p = 0.42810), type of symptoms (p = 0.20955), or Krouse staging (p = 0.23658). A significant impact on relapses was the position to Ohngren's plane (p = 0.004768) and tumor location in the anterior ethmoid (p = 0.00416). Endoscopic procedures are an effective method of IP treatment, however reasonable indications and surgeon experience should be taken into consideration.