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A Study of Surgical Procedures for Inverted Papilloma in the Nasal Cavity and Paranasal Sinuses

2008; Japanese Society of Otorhinolaryngology-Head and neck surgery; Volume: 111; Issue: 8 Linguagem: Inglês

10.3950/jibiinkoka.111.581

1883-0854

Ryo Endo, Junichi Ishitoya, Toshiro Kawano, Masahiro Yamada, Yasunori Sakuma, Osamu Shiono, Masanori Komatsu, Daiki Mitake, Yukiko Yamashita, Mamoru Tsukuda,

Oral and Maxillofacial Pathology

Inverted papilloma, although benign, recurs frequently and may become malignant, making definitive initial resection extremely important. We evaluated surgical procedures for recurrence and sites, with special reference to management of the orbital plate of the ethmoid and lacrimal bones, in 24 patients (32 cases) with inverted papilloma of the nasal cavity and paranasal sinuses undergoing surgical resection from 2000. Nine of the 32 showed recurrence, all around the ethmoid orbital plate. Up to 2002, recurrence was noted in 7 of 17 cases (41%), so we changed surgical selection criteria. Since 2003, we have conducted partial and combined excision of the orbital plate of the ethmoid and lacrimal bones (extended operation of the extranasal ethmoid and frontal sinuses) in cases in which tumors adhered to the orbital plate, noting recurrences in only 2 of 15 cases (13%). A number of reports advocate endoscopic sinus surgery to minimize invasiveness for inverted papilloma, but partial and combined excision of the orbital plate is indispensable, in progressive inverted papilloma cases to reduce recurrent.