Inverted Papilloma of the Nose and Paranasal Sinuses: Treatment Outcomes of 76 Cases

Chang, Young; Kim, Jae Ho; Kim, Yong Jae; Shin, Jung Eun; Lee, Bong Jae

Abstract

To learn the long-term effects of surgical treatment for inverted papilloma, we retrospectively studied 76 patients who underwent surgery for inverted papilloma between March 1990 and June 1997 and who followed up for at least one year. The patient pool consisted of 65 males and 11 females, and their ages ranged from 29 years to 81 years (mean age : 52 years). Twenty-eight patients (37%) had a history of previous nasal surgery, performed to treat nasal polyps with or without sinusitis. Conservative surgery resulted in four recurrences (16%) out of 25 patients, while medial maxillectomy resulted in three recurrences (6%) out of 47 patients. Endoscopic removal was performed in eight patients and resulted in one recurrence. Due to complications related to a medial maxillectomy, seven cases developed epiphora caused by stenosis of the lacrimal opening in the nasal cavity. The overall recurrence rate was 9%. Tumors recurred in four (67%) out of the six patients with associated carcinoma, one (13%) out of the eight patients with atypia, and two (3%) out of the 62 patients with inverted papilloma only. In conclusion, a preoperative biopsy is recommended for any unilateral polypoid nasal mass developed in adults. Medial maxillectomy may reduce the recurrence of inverted papilloma in spite of its disadvantages, which include external scarring and epiphora. Patients, especially those with associated atypia or carcinoma, should be followed up regularly for several years because of the high recurrence rate.