Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Apr;75(Suppl 1):785-792.
doi: 10.1007/s12070-022-03332-6. Epub 2022 Dec 19.

Exclusive Endoscopic Approach in the Management of Sinonasal Inverted Papilloma

Pradeep Pradhan  1 , Abhijeet Mishra  1 , C Preetam  1 , Pradipta Kumar Parida  1 , Saurav Sarkar  1 , Dillip Kumar Samal  1 , Swagatika Samal  2
Affiliations

Exclusive Endoscopic Approach in the Management of Sinonasal Inverted Papilloma

Pradeep Pradhan et al. Indian J Otolaryngol Head Neck Surg. 2023 Apr.

Abstract

Background: With the advancement in endoscopic endonasal surgeries, there has been a change in the surgical approach from the traditional open surgeries to the more conservative endoscopic endonasal approach for the management of sinonasal inverted papilloma. In the present study, we have shared our experience of endoscopic excision inverted papilloma involving the paranasal sinuses in a tertiary care hospital. Materials and methods: It is a retrospective case series of 28 patients who underwent endoscopic excision of inverted papilloma of paranasal sinus in a tertiary care hospital from April 2017 to October 2020. The medical records were retrospectively analyzed for the clinical, radiological, pathological, intraoperative and postoperative findings and later compared among the surgical approaches. Results: Of the total of 28 patients with inverted papilloma (3; Krouse 2 and 25; Krouse 3), 11(21.4%) patients were operated through endoscopic modified Denker, 8(39.3%) patients with endoscopic medial maxillectomy and 6(21.4%) patients with endoscopic sinus surgery. Patients who underwent modified endoscopic approach had lesser complications compared to the standard endoscopic procedures. Conclusion: Endoscopic excision of the sinonasal inverted papilloma can be a valid alternative to the open surgical approach, enabling complete clearance of the disease with a minimal complication rate. A large population with a long-term follow-up may be needed for a better understanding of the results.

Supplementary information: The online version contains supplementary material available at 10.1007/s12070-022-03332-6.

Keywords: Endoscopic approach; Inverted papilloma; Management.

PubMed Disclaimer

Conflict of interest statement

Disclosure of Potential Conflicts of InterestThere are no conflicts of interest among the authors.

Figures

Fig. 1
Fig. 1
 A. Non-contrast CT scan (coronal cuts) showing a soft tissue density in the left nasal cavity and the maxillary sinus with a focal hyperostosis over the medial wall of the maxillary sinus, suggesting the site of origin of tumour. B. Non-contrast CT scan(coronal cuts) showing a soft tissue density involving the left side of the nose and hyperostosis was found over the anterior ethmoid air cells
Fig. 2
Fig. 2
Contrast-enhanced MRI (T1-weighted, parasagittal and coronal cut) shows the typical convoluted cerebriform pattern in the left side of the nose involving the maxillary and ethmoid sinuses
Fig. 3
Fig. 3
A histopathological slide shows polyps lined by mature stratified squamous epithelium and endophytic growth/nests of mature squamous islands surrounded by oedematous stroma, suggestive of inverted papilloma (H& E 4x)
Fig. 4
Fig. 4
 A. Intraoperative photograph after endoscopic medial maxillectomy by modified endoscopic Denker. The black arrow shows the incised nasolacrimal duct. B. Intraoperative photograph of endoscopic pre-lacrimal crest approach. The white arrow shows the intact nasolacrimal duct and the black arrow indicates the preserved inferior turbinate
Fig. 5
Fig. 5
Bar diagram showing the involvement of tumours in various paranasal sinuses
Fig. 6
Fig. 6
Shows the site of origin of inverted papilloma in paranasal sinuses
See this image and copyright information in PMC

References

    1. Hosemann W, Scotti O, Bentzien S (2003 Sep-Oct) Evaluation of telescopes and forceps for endoscopic transnasal surgery on the maxillary sinus. Am J Rhinol 17(5):311–316 - PubMed
    1. Krouse JH (2000 Jun) Development of a staging system for inverted papilloma. Laryngoscope 110(6):965–968 - PubMed
    1. Han JK, Smith TL, Loehrl T, Toohill RJ, Smith MM (2001 Aug) An evolution in the management of sinonasal inverting papilloma. Laryngoscope 111(8):1395–1400 - PubMed
    1. Pagella F, Pusateri A, Giourgos G, Tinelli C, Matti E Evolution in the treatment of sinonasal inverted papilloma: pedicle-oriented endoscopic surgery.Am J Rhinol Allergy. 2014 Jan-Feb; 28(1):75–81 - PubMed
    1. Arunachalam P, King PA, Orford J (2003 Apr) A prospective comparison of tissue glue versus sutures for circumcision. Pediatr Surg Int 19(1–2):18–19 - PubMed

LinkOut - more resources