Abstract
BackgroundOur aim was to review our management of inverted papilloma (IP), perform a recurrence analysis, and review the literature.MethodsA retrospective analysis of 247 patients treated for an IP. Patients were grouped according to surgical approach, tumor presentation (primary, residual and recurrence) and Krouse-stage.ResultsRecurrence was observed in 20.3%, 28.6% and 35.1% (p = 0.017) of the patients who underwent endoscopic, external and combined surgery, respectively. Recurrences occurred more often in residual than primary IP (36.9% vs. 22.3%, p = 0.021). Primary endoscopic surgery had a recurrence rate of 12.5%, which was comparable to the recent literature (11.2%, 161/1433).ConclusionsThe relatively high number of recurrences in this cohort is explained by the long follow-up and previous (incomplete) surgery in 61.5% of the cases. The inferior outcome of residual IP underscores the importance of having a low threshold for preoperative biopsy in unilateral and atypical sinonasal disease.
Highlights
Our aim was to review our management of inverted papilloma (IP), perform a recurrence analysis, and review the literature
Since many researchers have contributed to the extensive knowledge we have on IP [3]
The aim of this study was to analyze the developments in our management of IP over the last three decades, in particular with regard to the recurrence rates and outcomes of treatment
Summary
Our aim was to review our management of inverted papilloma (IP), perform a recurrence analysis, and review the literature. Inverted papilloma (IP) is a benign tumor of the sinonasal cavities. It was first described by Ward more than 150 years ago as a follicular tumor involving the nasal bones [1]. It took until 1938 for Ringertz to recognize the characteristic endophytic growth pattern and introduce the term ‘inverting papilloma’ [2]. The incidence of IP ranges from 0.2 to 0.6 people diagnosed per 100,000 per year. IP is most commonly diagnosed in the fifth and sixth decade of life and has a predilection for males with a ratio of 3:1 [4]. The exact etiology of IP is unclear, but there are indications that HPV infection plays a role in the progression of
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