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. 2024 Aug;44(4):252-260.
doi: 10.14639/0392-100X-N2331.

Management of frontal sinus and frontal recess inverted papilloma: our experience and systematic review

Piergiorgio Gaudioso  1 , Alessandro Vinciguerra  2 , Benjamin Verillaud  2 , Philippe Herman  2
Affiliations

Management of frontal sinus and frontal recess inverted papilloma: our experience and systematic review

Piergiorgio Gaudioso et al. Acta Otorhinolaryngol Ital. 2024 Aug.

Abstract

Objective: For frontal sinus inverted papilloma (FSIP) management, an endoscopic endonasal approach (EEA) can be combined (or not) with an external approach by an osteoplastic flap (OPF) or with a more conservative open approach. The present study aims to describe our experience in the management of FSIP, focusing on disease-related and anatomical features influencing outcomes and recurrence.

Methods: This case series of FSIP investigated anatomical and disease-related predictors of recurrence associated with EEA or a combined EEA-OPF approach. A systematic review was also performed, selecting publications on IP with the insertion point in the frontal sinus or frontal recess.

Results: Among 30 patients included, 18 underwent EEA, while 12 received a combined EEA-OPF approach. During a median follow-up of 37 months, the frontal sinus was cleared of IP in all cases except 2 in the EEA group, who presented a complex posterior wall shape of the frontal sinus. From the systematic review, a combined EEA-OPF approach was associated with a lower risk of recurrence.

Conclusions: A correct indication for a combined EEA-OPF approach is paramount and should integrate all disease-related and anatomical features, including posterior wall shape.

Keywords: endoscopic surgery; frontal sinus; inverted papilloma; osteoplastic flap; skull base.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Cover figure.
Cover figure.
Two cases from the present series. A-B) Patient treated with combined endoscopic endonasal approach (EEA) and osteoplastic flap technique: A) An intraoperative detail at the end of the resection, revealing a defect in the posterior wall of the left frontal sinus, corresponding to the tumour’s insertion point; B) Preoperative radiological detail where the C-shaped conformation of the posterior wall of the frontal sinus is visible; C-D) Patient treated with exclusive EEA: C) Intraoperative detail at the end of resection, obtained through a Draf III procedure; the tumour insertion point resulted at the level of the frontal recess; D) Preoperative radiological detail where the straight conformation of the posterior wall of the frontal sinus is visible.
Figure 1.
Figure 1.
Radiological classification of posterior wall shape. A) Straight configuration; B) C-shape configuration; C) S-shape configuration. Yellow dotted lines represent the antero-posterior nasofrontal recess distance.
Figure 2.
Figure 2.
Radiological classification of lateral frontal sinus extension. A) Medial third extension; B) Central third extension; C) Lateral third extension.
See this image and copyright information in PMC

References

    1. Lisan Q, Laccourreye O, Bonfils P. Sinonasal inverted papilloma: from diagnosis to treatment. Eur Ann Otorhinolaryngol Head Neck Dis 2016;133:337-341. https://doi.org/10.1016/J.ANORL.2016.03.006 10.1016/J.ANORL.2016.03.006 - DOI - PubMed
    1. Kamel RH, Khaled A, Abdelfattah AF, et al. . Surgical treatment of sinonasal inverted papilloma. Curr Opin Otolaryngol Head Neck Surg 2022;30:26-32. https://doi.org/10.1097/MOO.0000000000000781 10.1097/MOO.0000000000000781 - DOI - PubMed
    1. Russo C, Elefante A, Romano A, et al. . A multimodal diagnostic approach to inverted papilloma: proposal of a novel diagnostic flow-chart. Curr Probl Diagn Radiol 2021;50:499-504. https://doi.org/10.1067/J.CPRADIOL.2020.04.009 10.1067/J.CPRADIOL.2020.04.009 - DOI - PubMed
    1. Lee JJ, Roland LT, Licata JJ, et al. . Morphologic, intraoperative, and histologic risk factors for sinonasal inverted papilloma recurrence. Laryngoscope 2020;130:590-596. https://doi.org/10.1002/lary.28078 10.1002/lary.28078 - DOI - PMC - PubMed
    1. Shohet JA, Duncavage JA. Management of the frontal sinus with inverted papilloma. Otolaryngol Head Neck Surg 1996;114:649-652. https://doi.org/10.1016/S0194-5998(96)70263-2 10.1016/S0194-5998(96)70263-2 - DOI - PubMed

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