Retrospective audit of sinonasal inverted papilloma at a tertiary care centre

Authors

  • Somu L. Department of Otorhinolaryngology, Head and Neck Surgery, Sri Ramachandra Medical College and Research Institute, Chennai, Tamil Nadu, India
  • Prasanna Kumar S. Department of Otorhinolaryngology, Head and Neck Surgery, Sri Ramachandra Medical College and Research Institute, Chennai, Tamil Nadu, India
  • Urvashi Singh Department of Otorhinolaryngology, Head and Neck Surgery, Sri Ramachandra Medical College and Research Institute, Chennai, Tamil Nadu, India

DOI:

https://doi.org/10.18203/issn.2454-5929.ijohns20172006

Keywords:

Inverted papilloma, Maxillectomy, Endoscopic sinus surgery, Management

Abstract

Background: Inverted Papilloma of the sinonasal tract is a benign neoplasm with unique locally destructive capacity, tendency to recur and a propensity for malignant change. Despite varied studies, there seems to be a lack in consensus with regards to its etiology, predictors of recurrence and malignant transformation. The aim of our study is to analyse the clinical profile, management and outcome of histopathologically proven Inverted Papilloma of the nose and paranasal sinus at our institute.

Methods: Retrospective chart review of 17 patients of histologically proven Sinonasal Inverted Papilloma over a period of 2 years from May 2013 to May 2015.

Results: The majority were in their 5th and 6th decade of life (47%) with a male to female ratio of 15:2. All had been managed surgically with 10 patients undergoing endoscopic assisted polypectomy, 6 requiring partial maxillectomy & 1 requiring total maxillectomy for complete surgical clearance. All patients had been followed up for a minimum duration of 1 year and recurrence was found in 41%. 2 patients had been diagnosed with malignant transformation during follow-up, out of which 1 underwent right partial maxillectomy along with concurrent chemotherapy and other patient underwent left total maxillectomy with concurrent chemotherapy and intensity modulated radiation therapy.

Conclusions: Inverted Papilloma of the sinonasal tract is a locally aggressive disease requiring careful endoscopic and radiological assessment. Adequate surgical management can ensure complete clearance of disease. A strict long term follow-up protocol will facilitate identifying recurrence and malignant transformation.

 

Author Biographies

Somu L., Department of Otorhinolaryngology, Head and Neck Surgery, Sri Ramachandra Medical College and Research Institute, Chennai, Tamil Nadu, India

Professor, Department of Otorhinolaryngology, Head & Neck Surgery

Prasanna Kumar S., Department of Otorhinolaryngology, Head and Neck Surgery, Sri Ramachandra Medical College and Research Institute, Chennai, Tamil Nadu, India

Professor, Department of Otorhinolaryngology, Head & Neck Surgery

Urvashi Singh, Department of Otorhinolaryngology, Head and Neck Surgery, Sri Ramachandra Medical College and Research Institute, Chennai, Tamil Nadu, India

Junior Resident, Department of Otorhinolaryngology, Head & Neck Surgery

References

Ridder GJ, Behringer S, Kayser G, Pfeiffer J. Malignancies arising in sinonasal inverted papillomas. Laryngorhinootologie. 2008;87(11):783-90.

Mirza S, Bradley PJ, Acharya A, Stacey M, Jones NS. Sinonasal inverted papillomas: recurrence, and synchronous and metachronous malignancy. J Laryngol Otol. 2007;121(09):857-64.

Woodruff WW, Vrabec DP. Inverted papilloma of the nasal vault and paranasal sinuses: spectrum of CT findings. AJR. Am J Roentgenol. 1994;162(2):419-23.

Batsakis JG, Suarez P. Schneiderian papillomas and carcinomas: a review. Adv Anat Pathol. 2001;8(2):53-64.

Nudell J, Chiosea S, Thompson LD. Carcinoma ex-Schneiderian papilloma (malignant transformation): a clinicopathologic and immunophenotypic study of 20 cases combined with a comprehensive review of the literature. Head Neck Pathol. 2014;8(3):269-86.

Stoddard DG, Keeney MG, Garcia JJ, O’Brien EK. Transcriptional Activity of HPV in Inverted Papilloma Demonstrated by In Situ Hybridization of HPV mRNA. Otolaryngol Head Neck Surg. 2015;152(4):752-8.

Kramer R, Som ML. True papilloma of the nasal cavity. Arch Otolaryngol. 1935;22(1):22-43.

Ringertz N. Pathology of malignant tumors arising in the nasal and paranasal cavities and sinuses. Acta Otolaryngologica (Stockholm). 1938;27.

Bielamowicz S, Calcaterra TC, Watson D. Inverting papilloma of the head and neck: the UCLA update. Otolaryngol Head Neck Surg. 1993;109(1):71-6.

Mirza S, Bradley PJ, Acharya A, Stacey M, Jones NS. Sinonasal inverted papillomas: recurrence, and synchronous and metachronous malignancy. J Laryngol Otol. 2007;121(09):857-64.

Sukenik MA, Casiano R. Endoscopic medial maxillectomy for inverted papillomas of the paranasal sinuses: value of the intraoperative endoscopic examination. Laryngoscope. 2000;110(1):39-42.

Woodson GE, Robbins KT, Michaels L. Inverted papilloma: considerations in treatment. Archives Otolaryngol. 1985;111(12):806-11.

Nielsen PL, Buchwald C, Nielsen LH, Tos M. Inverted papilloma of the nasal cavity: Pathological aspects in a follow‐up study. Laryngoscope. 1991;101(10):1094-101.

Christensen WN, Smith RR. Schneiderian papillomas: a clinicopathologic study of 67 cases. Human Pathol. 1986;17(4):393-400.

Batsakis JG, Suarez P. Schneiderian papillomas and carcinomas: a review. Adv Anat Pathol. 2001;8(2):53-64.

von Buchwald C, Bradley PJ. Risks of malignancy in inverted papilloma of the nose and paranasal sinuses. Current opinion in otolaryngology and head and neck surgery. 2007;15(2):95-8.

Karkos PD, Fyrmpas G, Carrie SC, Swift AC. Endoscopic versus open surgical interventions for inverted nasal papilloma: a systematic review. Clin Otolaryngol. 2006;31(6):499-503.

Strojan P, Jereb S, Borsos I, But-Hadzic J, Zidar N. Radiotherapy for inverted papilloma: a case report and review of the literature. Radiology and oncology. 2013;47(1):71-6.

Mendenhall WM, Hinerman RW, Malyapa RS, Werning JW, Amdur RJ, Villaret DB, et al. Inverted papilloma of the nasal cavity and paranasal sinuses. Am J Clin Oncol. 2007;30(5):560-3.

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Published

2017-06-24

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Original Research Articles