Evaluation of inverted papilloma recurrence rates and factors associated recurrence after endoscopic surgical resection: a retrospective review

Abstract Background Sinonasal inverted papillomas (IP) are benign tumours arising from the mucosal lining of the nasal cavity and paranasal sinuses with a high propensity for recurrence and malignant transformation. Advances in endoscopic surgery and improved radiologic navigation have increased the...

Full description

Saved in:
Bibliographic Details
Main Authors: Sheila Yu, Elysia Grose, Daniel J. Lee, Vincent Wu, Mitchell Pellarin, John M. Lee
Format: Article
Language:English
Published: SAGE Publishing 2023-04-01
Series:Journal of Otolaryngology - Head and Neck Surgery
Subjects:
Online Access:https://doi.org/10.1186/s40463-023-00638-5
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849435058952208384
author Sheila Yu
Elysia Grose
Daniel J. Lee
Vincent Wu
Mitchell Pellarin
John M. Lee
author_facet Sheila Yu
Elysia Grose
Daniel J. Lee
Vincent Wu
Mitchell Pellarin
John M. Lee
author_sort Sheila Yu
collection DOAJ
description Abstract Background Sinonasal inverted papillomas (IP) are benign tumours arising from the mucosal lining of the nasal cavity and paranasal sinuses with a high propensity for recurrence and malignant transformation. Advances in endoscopic surgery and improved radiologic navigation have increased the role of endoscopic surgical resection in the treatment of IPs. The current study aims to evaluate the rate of IP recurrence after endoscopic endonasal resection and to evaluate factors which impact recurrence. Methods This was a single-centre retrospective chart review of all patients who underwent endoscopic sinus surgery for management of IP between January 2009 and February 2022. Primary outcomes were the rate of IP recurrence and time to IP recurrence. Secondary outcome measures were patient and tumour factors that contributed to IP recurrence. Results Eighty-five patients were included. The mean age was 55.7 and 36.5% of patients were female. The mean follow-up time was 39.5 months. Of the 85 cases, 13 cases (15.3%) had recurrence of their IP and the median time to recurrence was 22.0 months. All recurrent tumours recurred at the attachment site of the primary tumour. The univariate analysis did not identify any significant demographic, clinical, or surgical predictors of IP recurrence. There were no significant changes in sinonasal symptoms at the time IP recurrence was detected. Conclusion Endoscopic endonasal resection of IPs represents an effective surgical approach, however, the relatively high rate of recurrence and lack of symptomatic changes at the time of recurrence necessitates long term follow up. Better delineation of risk factors for recurrence can help identify high-risk patients and inform postoperative follow up strategies.
format Article
id doaj-art-e4202f72434c451d9f5570b731258e24
institution Kabale University
issn 1916-0216
language English
publishDate 2023-04-01
publisher SAGE Publishing
record_format Article
series Journal of Otolaryngology - Head and Neck Surgery
spelling doaj-art-e4202f72434c451d9f5570b731258e242025-08-20T03:26:25ZengSAGE PublishingJournal of Otolaryngology - Head and Neck Surgery1916-02162023-04-015211810.1186/s40463-023-00638-5Evaluation of inverted papilloma recurrence rates and factors associated recurrence after endoscopic surgical resection: a retrospective reviewSheila Yu0Elysia Grose1Daniel J. Lee2Vincent Wu3Mitchell Pellarin4John M. Lee5Division of Rhinology, Department of Otolaryngology – Head and Neck Surgery, St. Michael’s Hospital, Unity Health Toronto, University of TorontoDivision of Rhinology, Department of Otolaryngology – Head and Neck Surgery, St. Michael’s Hospital, Unity Health Toronto, University of TorontoDepartment of Otorhinolaryngology-Head and Neck Surgery, Perelman School of Medicine, University of PennsylvaniaDivision of Rhinology, Department of Otolaryngology – Head and Neck Surgery, St. Michael’s Hospital, Unity Health Toronto, University of TorontoFaculty of Health Sciences, McMaster UniversityDivision of Rhinology, Department of Otolaryngology – Head and Neck Surgery, St. Michael’s Hospital, Unity Health Toronto, University of TorontoAbstract Background Sinonasal inverted papillomas (IP) are benign tumours arising from the mucosal lining of the nasal cavity and paranasal sinuses with a high propensity for recurrence and malignant transformation. Advances in endoscopic surgery and improved radiologic navigation have increased the role of endoscopic surgical resection in the treatment of IPs. The current study aims to evaluate the rate of IP recurrence after endoscopic endonasal resection and to evaluate factors which impact recurrence. Methods This was a single-centre retrospective chart review of all patients who underwent endoscopic sinus surgery for management of IP between January 2009 and February 2022. Primary outcomes were the rate of IP recurrence and time to IP recurrence. Secondary outcome measures were patient and tumour factors that contributed to IP recurrence. Results Eighty-five patients were included. The mean age was 55.7 and 36.5% of patients were female. The mean follow-up time was 39.5 months. Of the 85 cases, 13 cases (15.3%) had recurrence of their IP and the median time to recurrence was 22.0 months. All recurrent tumours recurred at the attachment site of the primary tumour. The univariate analysis did not identify any significant demographic, clinical, or surgical predictors of IP recurrence. There were no significant changes in sinonasal symptoms at the time IP recurrence was detected. Conclusion Endoscopic endonasal resection of IPs represents an effective surgical approach, however, the relatively high rate of recurrence and lack of symptomatic changes at the time of recurrence necessitates long term follow up. Better delineation of risk factors for recurrence can help identify high-risk patients and inform postoperative follow up strategies.https://doi.org/10.1186/s40463-023-00638-5Inverted papillomaSinonasal tumourEndoscopic sinus surgeryRecurrenceSNOT-22
spellingShingle Sheila Yu
Elysia Grose
Daniel J. Lee
Vincent Wu
Mitchell Pellarin
John M. Lee
Evaluation of inverted papilloma recurrence rates and factors associated recurrence after endoscopic surgical resection: a retrospective review
Journal of Otolaryngology - Head and Neck Surgery
Inverted papilloma
Sinonasal tumour
Endoscopic sinus surgery
Recurrence
SNOT-22
title Evaluation of inverted papilloma recurrence rates and factors associated recurrence after endoscopic surgical resection: a retrospective review
title_full Evaluation of inverted papilloma recurrence rates and factors associated recurrence after endoscopic surgical resection: a retrospective review
title_fullStr Evaluation of inverted papilloma recurrence rates and factors associated recurrence after endoscopic surgical resection: a retrospective review
title_full_unstemmed Evaluation of inverted papilloma recurrence rates and factors associated recurrence after endoscopic surgical resection: a retrospective review
title_short Evaluation of inverted papilloma recurrence rates and factors associated recurrence after endoscopic surgical resection: a retrospective review
title_sort evaluation of inverted papilloma recurrence rates and factors associated recurrence after endoscopic surgical resection a retrospective review
topic Inverted papilloma
Sinonasal tumour
Endoscopic sinus surgery
Recurrence
SNOT-22
url https://doi.org/10.1186/s40463-023-00638-5
work_keys_str_mv AT sheilayu evaluationofinvertedpapillomarecurrenceratesandfactorsassociatedrecurrenceafterendoscopicsurgicalresectionaretrospectivereview
AT elysiagrose evaluationofinvertedpapillomarecurrenceratesandfactorsassociatedrecurrenceafterendoscopicsurgicalresectionaretrospectivereview
AT danieljlee evaluationofinvertedpapillomarecurrenceratesandfactorsassociatedrecurrenceafterendoscopicsurgicalresectionaretrospectivereview
AT vincentwu evaluationofinvertedpapillomarecurrenceratesandfactorsassociatedrecurrenceafterendoscopicsurgicalresectionaretrospectivereview
AT mitchellpellarin evaluationofinvertedpapillomarecurrenceratesandfactorsassociatedrecurrenceafterendoscopicsurgicalresectionaretrospectivereview
AT johnmlee evaluationofinvertedpapillomarecurrenceratesandfactorsassociatedrecurrenceafterendoscopicsurgicalresectionaretrospectivereview