Main Article Content
Abstract
the nasal cavity and paranasal sinuses. It predominantly affects adults in their 50s, with a higher occurrence in
males. This condition has a notable recurrence rate and carries a risk of malignant transformation ranging from
5% to 15%.
Objective: This study aims to assess the effectiveness of endoscopic medial maxillectomy as a surgical
intervention for sinonasal IP, focusing on patient outcomes and recurrence rates.
Methods: In a retrospective descriptive cohort study conducted between January 2021 and February 2023 at
Sulaimany Teaching Hospital-Otolaryngology, Head and Neck Surgery Center and Middle East ENT Center at
Zhian Private Hospital, 11 patients were enrolled. Of these participants, 72.7% (8 cases) were male and 27.3%
(3 cases) were female, with a mean age of 45.45 years (range= 23-56). The patients underwent endoscopic
resection for sinonasal inverted papilloma and were assessed using endoscopy, sinonasal outcomes test (SNOT)-
22, radiological imaging, and histopathological examination.
Results: The study included 11 patients who underwent endoscopic resection for sinonasal inverted papilloma.
The examination of these patients revealed a higher prevalence of T2 stage (6 cases) and T3 stage (4 cases)
during the initial diagnosis. Furthermore, one occurrence of recurring disease and one instance of malignant
transformation were documented.
Conclusion: The results underscore the efficacy of modern endoscopic surgical techniques in efficiently treating
inverted papillomas, leading to improved patient outcomes, decreased recurrence rates, and enhanced overall
quality of life following the operation. These advances have successfully eradicated most inverted papillomas
endoscopically, resulting in good quality of life and low recurrence rates
Keywords
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References
- Adriaensen GF, Lim KH, Georgalas C, Reinartz SM, Fokkens WJ. Challenges in the management
- of inverted papilloma: a review of 72 revision cases. The Laryngoscope. 2016 Feb;126(2):322-8.
- Ahn SH, Lee EJ, Kim JW, Baek KH, Cho HJ, Yoon JH, Kim CH. Better surgical outcome by
- image-guided navigation system in endoscopic removal of sinonasal inverted papilloma. Journal
- of Cranio-Maxillofacial Surgery. 2018 Jun 1;46(6):937-41.
- Albert L. Rhoton. The Sellar Region. Neurosurgery, 2002. Vol. 51. No. 41.Pg. S335-74.
- Attlmayr B, Derbyshire SG, Kasbekar AV, Swift AC. Management of inverted papilloma. The
- Journal of Laryngology & Otology. 2017 Apr;131(4):284-9.
- Bertazzoni G, Accorona R, Schreiber A, Pietrobon G, Karligkiotis A, Fazio E, Castelnuovo P,
- Nicolai P. Postoperative long-term morbidity of extended endoscopic maxillectomy for inverted
- papilloma. Rhinology. 2017 Dec 1;55(4):319-25.
- Bugter O, Monserez DA, van Zijl FV, Baatenburg de Jong RJ, Hardillo JA. Surgical management
- of inverted papilloma; a single-center analysis of 247 patients with long followup. Journal of
- Otolaryngology-Head & Neck Surgery. 2017 Dec;46(1):1-7.
- Carta F, Verillaud B, Herman P. Role of endoscopic approach in the management of inverted
- papilloma. Current Opinion in Otolaryngology & Head and Neck Surgery. 2011 Feb 1;19(1):214.
- Coutinho G, Marques J, Leal M, Spratley J, Fernandes MS, Santos M. Surgical outcomes of
- sinonasal inverted papilloma: a 17 year review. Brazilian journal of otorhinolaryngology. 2020 Jul
- ;86:315-20.
- de Azevedo Caparroz F, Gregório LL, Kosugi EM. Evolution of endoscopic surgery in the
- treatment of inverted papilloma. Brazilian Journal of otorhinolaryngology. 2013 Jan 1;79(1):13-7.
- Dustin M. Dalgorf, Richard J. Harvey. Sinonasal Anatomy and Function. American Journal of
- Rhinology & Allergy. 2013. Vol. 27. No. 3.Pg. 3- 6.
- Eggers G, Mühling J, Hassfeld S. Inverted papilloma of paranasal sinuses. Journal of CranioMaxillofacial Surgery. 2007 Jan 1;35(1):21-9.
- Eide JG, Welch KC, Adappa ND, Palmer JN, Tong CC. Sinonasal Inverted Papilloma and
- Squamous Cell Carcinoma: Contemporary Management and Patient Outcomes. Cancers. 2022
- Jan;14(9):2195.
- Flood LM. Atlas of Sellar, Suprasellar, and Parasellar Lesions, Editor; Narayanan Janakiram,
- Assoc Editors; Dharambir S. Sethi and Shilpee Bhatia Sharma, Thieme 2021, Pages 462
- Illustrations 1097, ISBN: 9789388257534. The Journal of Laryngology & Otology.:1
- Goudakos JK, Blioskas S, Nikolaou A, Vlachtsis K, Karkos P, Markou KD. Endoscopic resection
- of sinonasal inverted papilloma: systematic review and meta-analysis. American Journal of
- Rhinology & Allergy. 2018 May;32(3):167-74.
- Hildenbrand T, Weber R, Mertens J, Stuck BA, Hoch S, Giotakis E. Surgery of inverted papilloma
- of the maxillary sinus via translacrimal approach—long-term outcome and literature review.
- Journal of clinical medicine. 2019 Nov 5;8(11):1873.
- Jiang XD, Dong QZ, Li SL, Huang TQ, Zhang NK. Endoscopic surgery of a sinonasal inverted
- papilloma: surgical strategy, follow-up, and recurrence rate. American Journal of Rhinology &
- Allergy. 2017 Jan;31(1):51-5.
- Kountakis SE, Senior BA, Draf W, editors. The frontal sinus. Berlin, Germany: Springer; 2005
- Dec 1.
- Landsberg R, Cavel O, Segev Y, Khafif A, Fliss DM. Attachment-oriented endoscopic surgical
- strategy for sinonasal inverted papilloma. American Journal of Rhinology. 2008 Nov;22(6):629-
- Lane AP, Bolger WE. Endoscopic management of inverted papilloma. Current Opinion in
- Otolaryngology & Head and Neck Surgery. 2006 Feb 1;14(1):14-8.
- Lee KJ. Essential otolaryngology: head and neck surgery. McGraw-Hill; 2012.
- Levine HL, Clemente P, editors. Sinus surgery: Endoscopic and microscopic approaches. Stuttgart:
- Georg Thieme Verlag; 2005.
- Lisan Q, Moya-Plana A, Bonfils P. Association of Krouse classification for sinonasal inverted
- papilloma with recurrence: a systematic review and meta-analysis. JAMA Otolaryngology–Head
- & Neck Surgery. 2017 Nov 1;143(11):1104-10.
- Minni A, Gera R, Bulgheroni C, Ralli M, Cialente F, Candelori F, Mevio N, Dragonetti A.
- Endoscopic resection of sinonasal inverted papilloma: a multivariate retrospective analysis of
- factors affecting recurrence and persistence. Ear, Nose & Throat Journal. 2021
- Sep;100(5_suppl):542S-8S.
- Mirza S, Bradley PJ, Acharya A, Stacey M, Jones NS. Sinonasal inverted papillomas: recurrence,
- and synchronous and metachronous malignancy. The Journal of Laryngology & Otology. 2007
- Sep;121(9):857-64.
- Pagella F, Pusateri A, Giourgos G, Tinelli C, Matti E. Evolution in the treatment of sinonasal
- inverted papilloma: pedicle-oriented endoscopic surgery. American journal of rhinology & allergy.
- Jan;28(1):75-81.
- Reh DD, Lane AP. The role of endoscopic sinus surgery in the management of sinonasal inverted
- papilloma. Current Opinion in Otolaryngology & Head and Neck Surgery. 2009 Feb 1;17(1):6-10.
- Safadi A, Yafit D, Abu-Ghanem S, Ungar OJ, Wengier A, Abergel A, Fliss DM, Koren I. The
- clinical behavior of sinonasal inverted papilloma with cellular dysplasia: case series and review of
- the literature. European Archives of Oto-Rhino-Laryngology. 2017 Sep;274(9):3375-82.
- Sbrana MF, Borges RF, Pinna FD, Brandão Neto D, Voegels RL. Sinonasal inverted papilloma:
- rate of recurrence and malignant transformation in 44 operated patients. Brazilian journal of
- otorhinolaryngology. 2021 Mar 15;87:80-4.
- Schneyer MS, Milam BM, Payne SC. Sites of attachment of Schneiderian papilloma: a
- retrospective analysis. InInternational forum of allergy & rhinology 2011 Jul (Vol. 1, No. 4, pp.
- -328). Hoboken: Wiley Subscription Services, Inc., A Wiley Company.
- Stammberger, H, and Valerie Lund. Anatomy of the nose and paranasal sinuses, Scott Brown
- Otorhinolaryngology Head and Neck Surgery .8thEd. 2018. Vol. 1.Pg. 968-972.
- Tabaee A. The Maxillary Sinus: Medical and Surgical Management. The Annals of Otology,
- Rhinology & Laryngology. 2011 Aug 1;120(8):560.
- Ungari C, Riccardi E, Reale G, Agrillo A, Rinna C, Mitro V, Filiaci F. Management and treatment
- of sinonasal inverted papilloma. Annali di stomatologia. 2015 Jul;6(3-4):87.
- van Samkar A, Georgalas C. Long-term quality of life after endoscopic removal of sinonasal
- inverted papillomas: a 6-year cohort analysis in a tertiary academic hospital. European Archives
- of Oto-Rhino-Laryngology. 2016 Jun;273(6):1433-7.
- Wang J, Bidari S, Inoue K, Yang H, Rhoton A Jr. Extensions of the sphenoid sinus: a new
- classification. Neurosurgery 2010;66(4):797–816
References
Adriaensen GF, Lim KH, Georgalas C, Reinartz SM, Fokkens WJ. Challenges in the management
of inverted papilloma: a review of 72 revision cases. The Laryngoscope. 2016 Feb;126(2):322-8.
Ahn SH, Lee EJ, Kim JW, Baek KH, Cho HJ, Yoon JH, Kim CH. Better surgical outcome by
image-guided navigation system in endoscopic removal of sinonasal inverted papilloma. Journal
of Cranio-Maxillofacial Surgery. 2018 Jun 1;46(6):937-41.
Albert L. Rhoton. The Sellar Region. Neurosurgery, 2002. Vol. 51. No. 41.Pg. S335-74.
Attlmayr B, Derbyshire SG, Kasbekar AV, Swift AC. Management of inverted papilloma. The
Journal of Laryngology & Otology. 2017 Apr;131(4):284-9.
Bertazzoni G, Accorona R, Schreiber A, Pietrobon G, Karligkiotis A, Fazio E, Castelnuovo P,
Nicolai P. Postoperative long-term morbidity of extended endoscopic maxillectomy for inverted
papilloma. Rhinology. 2017 Dec 1;55(4):319-25.
Bugter O, Monserez DA, van Zijl FV, Baatenburg de Jong RJ, Hardillo JA. Surgical management
of inverted papilloma; a single-center analysis of 247 patients with long followup. Journal of
Otolaryngology-Head & Neck Surgery. 2017 Dec;46(1):1-7.
Carta F, Verillaud B, Herman P. Role of endoscopic approach in the management of inverted
papilloma. Current Opinion in Otolaryngology & Head and Neck Surgery. 2011 Feb 1;19(1):214.
Coutinho G, Marques J, Leal M, Spratley J, Fernandes MS, Santos M. Surgical outcomes of
sinonasal inverted papilloma: a 17 year review. Brazilian journal of otorhinolaryngology. 2020 Jul
;86:315-20.
de Azevedo Caparroz F, Gregório LL, Kosugi EM. Evolution of endoscopic surgery in the
treatment of inverted papilloma. Brazilian Journal of otorhinolaryngology. 2013 Jan 1;79(1):13-7.
Dustin M. Dalgorf, Richard J. Harvey. Sinonasal Anatomy and Function. American Journal of
Rhinology & Allergy. 2013. Vol. 27. No. 3.Pg. 3- 6.
Eggers G, Mühling J, Hassfeld S. Inverted papilloma of paranasal sinuses. Journal of CranioMaxillofacial Surgery. 2007 Jan 1;35(1):21-9.
Eide JG, Welch KC, Adappa ND, Palmer JN, Tong CC. Sinonasal Inverted Papilloma and
Squamous Cell Carcinoma: Contemporary Management and Patient Outcomes. Cancers. 2022
Jan;14(9):2195.
Flood LM. Atlas of Sellar, Suprasellar, and Parasellar Lesions, Editor; Narayanan Janakiram,
Assoc Editors; Dharambir S. Sethi and Shilpee Bhatia Sharma, Thieme 2021, Pages 462
Illustrations 1097, ISBN: 9789388257534. The Journal of Laryngology & Otology.:1
Goudakos JK, Blioskas S, Nikolaou A, Vlachtsis K, Karkos P, Markou KD. Endoscopic resection
of sinonasal inverted papilloma: systematic review and meta-analysis. American Journal of
Rhinology & Allergy. 2018 May;32(3):167-74.
Hildenbrand T, Weber R, Mertens J, Stuck BA, Hoch S, Giotakis E. Surgery of inverted papilloma
of the maxillary sinus via translacrimal approach—long-term outcome and literature review.
Journal of clinical medicine. 2019 Nov 5;8(11):1873.
Jiang XD, Dong QZ, Li SL, Huang TQ, Zhang NK. Endoscopic surgery of a sinonasal inverted
papilloma: surgical strategy, follow-up, and recurrence rate. American Journal of Rhinology &
Allergy. 2017 Jan;31(1):51-5.
Kountakis SE, Senior BA, Draf W, editors. The frontal sinus. Berlin, Germany: Springer; 2005
Dec 1.
Landsberg R, Cavel O, Segev Y, Khafif A, Fliss DM. Attachment-oriented endoscopic surgical
strategy for sinonasal inverted papilloma. American Journal of Rhinology. 2008 Nov;22(6):629-
Lane AP, Bolger WE. Endoscopic management of inverted papilloma. Current Opinion in
Otolaryngology & Head and Neck Surgery. 2006 Feb 1;14(1):14-8.
Lee KJ. Essential otolaryngology: head and neck surgery. McGraw-Hill; 2012.
Levine HL, Clemente P, editors. Sinus surgery: Endoscopic and microscopic approaches. Stuttgart:
Georg Thieme Verlag; 2005.
Lisan Q, Moya-Plana A, Bonfils P. Association of Krouse classification for sinonasal inverted
papilloma with recurrence: a systematic review and meta-analysis. JAMA Otolaryngology–Head
& Neck Surgery. 2017 Nov 1;143(11):1104-10.
Minni A, Gera R, Bulgheroni C, Ralli M, Cialente F, Candelori F, Mevio N, Dragonetti A.
Endoscopic resection of sinonasal inverted papilloma: a multivariate retrospective analysis of
factors affecting recurrence and persistence. Ear, Nose & Throat Journal. 2021
Sep;100(5_suppl):542S-8S.
Mirza S, Bradley PJ, Acharya A, Stacey M, Jones NS. Sinonasal inverted papillomas: recurrence,
and synchronous and metachronous malignancy. The Journal of Laryngology & Otology. 2007
Sep;121(9):857-64.
Pagella F, Pusateri A, Giourgos G, Tinelli C, Matti E. Evolution in the treatment of sinonasal
inverted papilloma: pedicle-oriented endoscopic surgery. American journal of rhinology & allergy.
Jan;28(1):75-81.
Reh DD, Lane AP. The role of endoscopic sinus surgery in the management of sinonasal inverted
papilloma. Current Opinion in Otolaryngology & Head and Neck Surgery. 2009 Feb 1;17(1):6-10.
Safadi A, Yafit D, Abu-Ghanem S, Ungar OJ, Wengier A, Abergel A, Fliss DM, Koren I. The
clinical behavior of sinonasal inverted papilloma with cellular dysplasia: case series and review of
the literature. European Archives of Oto-Rhino-Laryngology. 2017 Sep;274(9):3375-82.
Sbrana MF, Borges RF, Pinna FD, Brandão Neto D, Voegels RL. Sinonasal inverted papilloma:
rate of recurrence and malignant transformation in 44 operated patients. Brazilian journal of
otorhinolaryngology. 2021 Mar 15;87:80-4.
Schneyer MS, Milam BM, Payne SC. Sites of attachment of Schneiderian papilloma: a
retrospective analysis. InInternational forum of allergy & rhinology 2011 Jul (Vol. 1, No. 4, pp.
-328). Hoboken: Wiley Subscription Services, Inc., A Wiley Company.
Stammberger, H, and Valerie Lund. Anatomy of the nose and paranasal sinuses, Scott Brown
Otorhinolaryngology Head and Neck Surgery .8thEd. 2018. Vol. 1.Pg. 968-972.
Tabaee A. The Maxillary Sinus: Medical and Surgical Management. The Annals of Otology,
Rhinology & Laryngology. 2011 Aug 1;120(8):560.
Ungari C, Riccardi E, Reale G, Agrillo A, Rinna C, Mitro V, Filiaci F. Management and treatment
of sinonasal inverted papilloma. Annali di stomatologia. 2015 Jul;6(3-4):87.
van Samkar A, Georgalas C. Long-term quality of life after endoscopic removal of sinonasal
inverted papillomas: a 6-year cohort analysis in a tertiary academic hospital. European Archives
of Oto-Rhino-Laryngology. 2016 Jun;273(6):1433-7.
Wang J, Bidari S, Inoue K, Yang H, Rhoton A Jr. Extensions of the sphenoid sinus: a new
classification. Neurosurgery 2010;66(4):797–816
