gms | German Medical Science

76. Jahresversammlung der Deutschen Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie e. V.

Deutsche Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie e. V.

04.05. - 08.05.2005, Erfurt

Inverted papillomas of the nasal cavity and paranasal sinuses : cinical and diagnostic aspects and therapeutic results

Meeting Abstract

  • corresponding author Stefanie Behringer - Dept. of Otorhinolaryngology - Head and Neck Surgery, University of Freiburg, Freiburg
  • author Gian Kayser - Dept. of Pathology, Freiburg
  • author Carsten C. Boedeker - Dept. of Otorhinolaryngology - Head and Neck Surgery, University of Freiburg, Freiburg
  • author Gerd J. Ridder - Dept. of Otorhinolaryngology - Head and Neck Surgery, University of Freiburg, Freiburg

Deutsche Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie. 76. Jahresversammlung der Deutschen Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie e.V.. Erfurt, 04.-08.05.2005. Düsseldorf, Köln: German Medical Science; 2005. Doc05hno668

Die elektronische Version dieses Artikels ist vollständig und ist verfügbar unter: http://www.egms.de/de/meetings/hno2005/05hno191.shtml

Veröffentlicht: 22. September 2005

© 2005 Behringer et al.
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Gliederung

Text

The optimal treatment of inverted papilloma (IP) of the nose and paranasal sinuses is a challenge for the otolaryngologist because of its still unknown aetiology, its locally destructive growth, its tendency to recur and its propensity to be associated with malignancy.

In a retrospective study, we analysed the patients with sinonasal inverted papillomas, who had been operated at our department, during the 15-year period from 1990 to 2005 (n=76). We determined the extension of the tumour according to the staging system by Krouse. The mean follow-up period was 22,9 months. The average age was 61,9 years (median 62 years). 15 patients were referred to us with recurrent IP, yet operated elsewhere before.

The most frequent presenting complaint was nasal obstruction, being reported in 97% of all cases. The primary sites of origin were the ethmoid sinus (n=39), the nasal cavity (n=29) and the maxillary sinus (n=26). Dependent on the status of recurrence and on the location of the tumour, the surgical approach was either made endo-microscopic or endoscopic with navigation control, respectively by an external approach. In cases of an IP localized in the maxillary sinus, we prefer the Caldwell-Luc procedure to remove all the affected mucous membrane.

What is conspicuous to us, is the high general recurrence rate of 35,5%. Malignant transformation on the ground of an IP was found in 9 of 76 patients (11,8%). In 5 of these cases it concerns a primary manifestation of the tumour and in the other 4 cases the malignancy was found in a recurrence of the IP.

In view of the high recurrence rate, the locally destructive growth and the high rate of malignant transformation, surgeons should pursue the therapeutic concept of a local radical and function-preserving surgery of the nose and paranasal sinuses.