Jentashapir Journal of Cellular and Molecular Biology
Inverted papillomas comprise 0.5% - 4% of benign epithelial nasal tumors that arise primarily from the lateral nasal wall. The main characteristic is their tendency to recur and the risk of malignant transformation.
The aim of this study was to report on our experience in the treatment of these lesions, especially through the endoscopic approach, and the outcome of the patients.
This is a retrospective report describing 38 patients who underwent endoscopic excision or open surgery from March 2001 to March 2012. The patients were studied by consideration of their age, gender, origin of lesion, presenting symptoms, radiological studies, clinical staging, method of treatment, follow up, surgical outcome, tumor recurrence and associated malignancy. The mean follow-up was 47.84 months.
There were 30 males and eight females, and the mean age was 49.76 years ranging from 18 to 78 years. The most common clinical symptoms were unilateral nasal obstruction (94.7%) and rhinorrhea (36.84%). Disease recurrence rate was 5.3%. Endonasal endoscopic resection was performed for 32 patients (84.2%), combined approaches were used for five patients (13.2%) and external approach was only done for one patient. The most common involvement location was the maxillary sinus (89%). The ethmoid sinus and the lateral nasal wall were involved in 68% and 55.2% of the cases, respectively. Malignant transformation was observed in two patients (5.3%).
Long-term follow up of inverted papilloma is necessary for early detection of recurrence and to allow for surgical salvage. Surgeons experience plays a decisive role in the selection of an appropriate method.
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