Abstract
Introduction: Sinonasal inverted papilloma (SNIP) is a rare, benign tumour originating from the mucosal lining of the sinonasal cavity. The treatment is aimed at complete tumour resection. Current resection methods include external excision, endoscopic surgery and a combined approach. The high rate of SNIP recurrence poses a challenge for the ear nose and throat (ENT) specialist. There is a debate about which method provides the best outcomes. In this study, the most recent literature is analysed to evaluate the effectiveness of each surgical approach in terms of recurrence rate and surgical complications.
Results: The literature search yielded data for 941 patients from ten studies. The analysis showed a recurrence rate of 13.5% for the endoscopic approach, 34% for combined and 36.7% for the external. The lowest recurrence rate (0%-3.6%) was reported when novel endoscopic approaches, such as prelacrimal recess or ‘TuNa’ saving, were used. However, the comparison of surgical complications was challenging due to inconsistent reporting.
Discussion: The external approach previously considered a ‘gold standard’ is now becoming replaced by endoscopic surgery. The advantages of an endoscopic approach are a lower recurrence rate, better visualisation of the tumour and a more precise excision. Moreover, this approach preserves the surrounding tissues, reducing the amount of complications and recovery time. However, the external approach should still be employed when SNIP is widespread or in proximity with vital structures. Careful pre-operative planning is needed as the primary surgery has the best chances of eliminating the disease. Each revision surgery subsequently increases the risk of SNIP recurrence. Furthermore, there is a need for agreement on minimal surveillance time after SNIP resection.
Conclusion: The endoscopic approach should be a mainstay of SNIP treatment due to low recurrence rate and better patient outcomes. Nevertheless, ENT specialists should keep in mind that for more advanced disease, external an combined methods may be more appropriate.
References
Attlmayr B, Derbyshire SG, Kasbekar AV, Swift AC.Management of inverted papilloma: review. J Laryngol Otol 2017;131(4):284–9. Available from: https://doi.org/10.1017/S0022215117000172
Wang M, Noel JE. Etiology of sinonasal inverted papilloma: a narrative review. World J Otorhinolaryngol- Head Neck Surg 2017;3(1):54–8. Available from: https://doi.org/10.1016/j.wjorl.2016.11.004
Lisan Q, Laccourreye O, Bonfils P. Sinonasal inverted papilloma: from diagnosis to treatment. Eur Ann Otorhinolaryngol Head Neck Dis 2016;133(5):337–41. Available from: https://doi.org/10.1016/j.anorl.2016.03.006
Radiopaedia.org. Inverted papilloma. Available from:https://radiopaedia.org/cases/inverted-papilloma-5?lang=gb (accessed 30.6.19).
Krouse JH. Development of a staging system for inverted papilloma. Laryngoscope 2000;110(6):965–8. Available from: https://doi.org/10.1097/00005537-200006000-00015
Ungari C, Riccardi E, Reale G, et al. Management and treatment of sinonasal inverted papilloma. Ann Stomatol (Roma) 2015;6(3-4):87–90. Available from: https://doi.org/10.11138/ads/2015.6.3.087
Lund VJ, Clarke PM, Swift AC, McGarry GW, Kerawala C, Carnell D. Nose and paranasal sinus tumours: United Kingdom National Multidisciplinary Guidelines. J Laryngol Otol 2016;130(S2):S111-S118. Available from: https://doi.org/10.1017/S0022215116000530
Nygren A, Kiss K, von Buchwald C, Bilde A. Rate of recurrence and malignant transformation in 88 cases with inverted papilloma between 1998-2008. Acta Otolaryngol 2016;136(3):333–6. Available from: https://doi.org/10.3109/00016489.2015.1116123
Kim HJ, Kim C-H, Kang J-W, et al. A modified midfacial degloving approach for the treatment of unilateral paranasal sinus tumours. J Cranio-Maxillofacial Surg 2011;39:284–8. Available from: https://doi.org/10.1016/j.jcms.2010.06.006
Waitz G, Wigand ME. Results of endoscopic sinus surgery for the treatment of inverted papillomas. Laryngoscope 1992;102(8):917–22. Available from: https://doi.org/10.1288/00005537-199208000-00012
Pagella F, Pusateri A, Matti E, et al. “TuNa-saving” endoscopic medial maxillectomy: a surgical technique for maxillary inverted papilloma. Eur Arch Oto-Rhino-Laryngolog 2017;274(7):2785–91. Available from: https://doi.org/10.1007/s00405-017-4549-0
Yu Q-Q, Guan G, Zhang N-K, et al. Intranasal endoscopic prelacrimal recess approach for maxillary sinus inverted papilloma. Eur Arch Oto-Rhino-Laryngology 2018;275(9):2297–302. Available from: https://doi.org/10.1007/s00405-018-5078-1
Ahn SH, Lee EJ, Kim JW, et al. Better surgical outcome by image-guided navigation system in endoscopic removal of sinonasal inverted papilloma. J Craniomaxillofac Surg 2018;46(6):937–41. Available from: https://doi.org/10.1016/j.jcms.2018.03.012
Approach - Lateral Rhinotomy - AO Surgery Reference. [cited 2019 Apr 8]. Available from: https://www2.aofoundation.org/wps/portal/surgery.
Midface - Approach - Approaches to the maxilla - AO Surgery Reference. [cited 2019 Apr 8]. Available from: https://www2.aofoundation.org/wps/portal/surgery.
Medical Illustration Gallery. [cited 2019 Apr 8]. Available from: http://chrisgralapp.com/medical.html.
Pai PS, Moiyadi A, Nair D. Endoscopic v/s conventional approach to sino-nasal tumours - What’s the debate? Indian J Surg Oncol 2010;1(2):194–9. Available from: https://doi.org/10.1007/s13193-010-0032-8
Kim JS, Kwon SH. Recurrence of sinonasal inverted papilloma following surgical approach: a meta-analysis. Laryngoscope 2017;127(1):52–8. Available from: https://doi.org/10.1002/lary.26222
Kamel RH, Abdel Fattah AF, Awad AG. Transnasal endoscopic medial maxillectomy in recurrent maxillary sinus inverted papilloma. Rhinology 2014;52(4):381–5. Available from: https://doi.org/10.4193/Rhin13.230
Sciarretta V, Fernandez IJ, Farneti P, Pasquini E. Endoscopic and combined external–transnasal endoscopic approach for the treatment of inverted papilloma: analysis of 110 cases. Eur Arch Oto-Rhino-Laryngology 2014;271(7):1953–9. Available from: https://doi.org/10.1007/s00405-013-2817-1
Kadapa NPB, Reddy LS, Reddy V, Kumuda P, Reddy MVV, Rao LMSCS. Nasal endoscope: an armamentarium in the management of sinonasal inverted papilloma. Indian J Otolaryngol Head Neck Surg 2014;66(2):200–4. Available from: https://doi.org/10.1007/s12070-014-0716-4.
Zydroń R, Wierzbicka M, Greczka G. Clinical outcomes of treatment of sinonasal inverted papillomas (IPs) depending on the surgical technique and learning curve. Otolaryngol Pol 2016;70(6):1–5. Available from: https://doi.org/10.5604/01.3001.0009.3736
Bugter O, Monserez DA, van Zijl FVWJ, Baatenburg de Jong RJ, Hardillo JA. Surgical management of inverted papilloma; a single-center analysis of 247 patients with long follow-up. J Otolaryngol - Head Neck Surg 2017;46(1):67. Available from: https://doi.org/10.1186/s40463-017-0246-7
Wu V, Siu J, Yip J, Lee JM. Endoscopic management of maxillary sinus inverted papilloma attachment sites to minimize disease recurrence. J Otolaryngol Head Neck Surg 2018;47(1):24. Available from: https://doi.org/10.1186/s40463-018-0271-1
Peng R, Thamboo A, Choby G, Ma Y, Zhou B, Hwang PH. Outcomes of sinonasal inverted papilloma resection by surgical approach: an updated systematic review and meta-analysis. Int Forum Allergy Rhinol 2019;9(6):573- 581. Available from: https://doi.org/10.1002/alr.22305
Kim D-Y, Hong S-L, Lee CH, et al. Inverted papilloma of the nasal cavity and paranasal sinuses: a Korean multicenter study. Laryngoscope 2012;122(3):487–94. Available from: https://doi.org/10.1002/lary.22495
Suh JD, Chiu AG. What are the surveillance recommendations following resection of sinonasal inverted papilloma? Laryngoscope 2014;124(9):1981–2. Available from: https://doi.org/10.1002/lary.24611