Our Experience with Inverted Papilloma: about 61 Patients

Abstract

Introduction: Inverted papilloma (IP) is the most common type of Schneiderian papilloma originating from the mucosal lining of the nose and paranasal cavities. It is a semi benign tumor with a high tendency for recurrences and malignant transformation. Management consists of a complete tumoral resection. Objective: to analyze surgical results considering the techniques (open or endoscopic surgery), the rate and time of recurrence. Method: We present herein a cohort of 61 patients treated in the CHU-UCL Godinne between 1998 and 2019. We analyzed the demographic data, the origin of the tumor, the staging, the surgical approach and the outcomes. The patients were classified into two groups: the first one includes 48 patients operated de novo in CHU-UCL Godinne and the second group 13 patients referred to us for revision surgery. Results: We observed 8 recurrences, all groups confounded. The global success rate was 87%. The number of recurrences in the first group was 6 out of 48 and 2 out of 13 in the second group. Following these results we propose an algorithm of treatment depending on the site of attachment of the IP. Conclusion: We confirmed that more extended surgeries such as Caldwell Luc procedure, medial maxillectomy, Draf IIb/III frontal sinusotomy or type III sphenoidotomy give better outcomes than more “limited” and functional surgeries such as Draf I/IIa frontal sinusotomy or middle antrostomy. The latter should be done only for specific and limited extension of the IP in the maxillary sinus. A subperiosteal dissection is mandatory in all cases. Keywords: inverted papilloma; retrospective study; surgery; recurrence