Dear Editor, Papillomas are primary benign epithelial neoplasms producing finger–like projections that typically cover fibrous stalks.1 The term Inverted Papilloma (IP) describes the endophytic projection of epithelium into the stroma. Also known as Schneiderian papillomas, IPs predominantly affect males in the 6th decade.2 They usually arise from the lateral nasal wall and seldom involve the frontal or sphenoid sinuses.2 The frequency of IP on the nasal septum is even less.3 We report a case of IP of the nasal septum and the role of endoscopic resection of the IP without any sign of recurrence.
Human ; Male ; Middle Aged ; Nasal Septum ; Papilloma, Inverted-surgery, treatment ; nose ; neoplasms

Objective:To investigate the effectiveness of nasal endoscopic anterior lacrimal recess approach combined with temporary fenestration of the nasal septum in resecting recurrent nasal inverted papilloma. Methods:Patients with recurrent nasal inverted papilloma who underwent reoperation in our hospital during the past 2 years were included . The nasal septum may hinder full access to and effective treatment of the lesions at the anterior and medial wall of the maxillary sinus by endoscope, aspirator and surgical instrument in the narrow aperture of the prelacrimal recess, although these lesions could be observed by 70° nasal endoscope. Results:The nasal septum is temporarily opened on the basis of the prelacrimal recess approach, and the nasal endoscope and instrument was introduced through trans-septal window, so as to provide a better view of the operative field and the angular range of the instrument's movement. Conclusion:The recurrent nasal inverted papilloma could be successfully managed by re-endoscopic anterior lacrimal recess approach combined with temporary fenestration of the nasal septum, and no recurrence was observed during the 2-year follow-up. This surgical approach is recommended for the inverted papilla which originates from the anterior medial wall of the maxillary sinus, as the tumor can be removed completely using this surgical approach.
Humans ; Papilloma, Inverted/pathology* ; Endoscopy ; Maxillary Sinus/pathology* ; Lacrimal Apparatus/surgery* ; Treatment Outcome ; Retrospective Studies

OBJECTIVE: To evaluate the curative effect of endoscopic surgery (ESS) in the treatment of inverted papillomas in the nasal cavity and paranasal sinus. METHOD: We report on 16 clinicopathologic cases of inverted papilloma. After preoperative endoscopic examination and CT screening, endoscopic sinus surgery was performed under general anesthesia. RESULT: The follow-up period ranged between one year to two years. Recurrence was observed in 2 cases. CONCLUSION The nasal endoscopy is a better method for treating Krouse I-II stage nasal inverted papilloma. The advantages of endoscopic surgery include clear visual field, less bleeding, limited reoccurrence, and avoidance of facial incision.
Adult ; Aged ; Endoscopy ; Female ; Humans ; Male ; Middle Aged ; Neoplasm Staging ; Nose Neoplasms ; surgery ; Papilloma, Inverted ; surgery ; Treatment Outcome ; Young Adult

OBJECTIVETo evaluate the effect of endoscopic resection and traditional procedure in the management of sinonasal inverted papilloma with a staging system based on endoscopic examination of the nasal cavity and computed tomography (CT) scan evaluation.

METHODSTwo hundred and twenty-two patients with sinonasal inverted papilloma treated surgically were retrospectively reviewed. There were 23 cases in stage I; 119 cases in stage II; 65 cases in stage III and 15 cases in stage IV. Among these patients, 122 cases were treated endoscopically; 100 cases were treated by traditional surgical techniques, including 56 cases with lateral rhinotomy; 27 cases with intranasal approach and 15 cases with Caldwell-Luc technique.

RESULTSThe inverted papilloma was removed completely and no serious complications were encountered by all four kinds of techniques used. With an average follow-up of 3. 8 years, the recurrence rate for endoscopic group was 14.8% (18/122, four patients were in group I; nine in group II; four in group III; and one patient in group IV. No recurrence was found in group III who underwent endoscopic excision combined with Caldwell-Luc procedure. The recurrence rate for lateral rhinotomy group was 33. 9% (19/56, one patients in group I; six in group II; nine in group III; three in group IV). The recurrence rate for intranasal approach group was 51.9% (14/27, two patients were in group I; ten in group II; and two in group III). The recurrence rate for Caldwell-Luc procedure group was 29.4% (5/17, all in group II and group III). Regardless of approaches, patients who had primary resection had a recurrence of 26. 8%, whereas those with secondary resection had a recurrence of 20. 9% (P = 0.39).

CONCLUSIONSThe endoscopic surgical technique was proved to be a better method for treating sinonasal inverted papilloma in stage I and stage II. Better results for patients in stage III would be achieved by combining endoscopic technique with Caldwell-Luc procedure. As to patients with stage IV, radical external approaches should be considered.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Endoscopy ; Female ; Humans ; Male ; Middle Aged ; Otorhinolaryngologic Surgical Procedures ; Papilloma, Inverted ; surgery ; Paranasal Sinus Neoplasms ; surgery ; Retrospective Studies ; Treatment Outcome ; Young Adult

OBJECTIVETo introduce the experience of management of inverted papilloma in frontal sinus in hospital.

METHODSSix patients with inverted papilloma in frontal sinus treated between 1999 and 2006 were reported, with special emphasis on the clinical symptoms, surgical technique and prognosis.

RESULTSAmong 6 patients with frontal sinus involvement, there were 5 males and 1 female, aged between 24 and 66 years. All 6 patients were managed with endoscopic resection and additional open approach (glabellar nasal keyhole approach). Follow-up ranged from 2 -8 years. Five patients treated with this protocol remained disease free, and 1 patient died of tumor recurrence and malignant degeneration 16 years after the first surgical management of sinonasal inverted papilloma.

CONCLUSIONSThe appropriate management of inverted papilloma involving the frontal sinus is combined open/endoscopic approach. The tumor extended into the lateral, far superior, and anterior aspects of the frontal sinus is truly at the limits of current endoscopic instrumentation. In order to avoid recurrence, the tumor must be resected completely during the operation. Postoperative radiotherapy is not absolutely necessary.

Adult ; Aged ; Endoscopy ; Female ; Frontal Sinus ; pathology ; Humans ; Male ; Middle Aged ; Otorhinolaryngologic Surgical Procedures ; methods ; Papilloma, Inverted ; surgery ; Paranasal Sinus Neoplasms ; surgery ; Treatment Outcome

OBJECTIVETo evaluate the effect of endoscopic surgery using the low-temperature plasma radiofrequency for nasal inverted papilloma. Methods In a retrospective study, clinical data of 8 patients underwent endoscopic surgery were analyzed since July 2008. Tumor stage according to Krouse was T1:1, T2:6, T3:1, T4:0, respectively. T1 and T2 lesions were completed excised using the low-temperature plasma radiofrequency, T3 lesions were excised using microdebrider combined with plasma radiofrequency.

RESULTSThe average blood loss was about 20 ml, with the exception of one patients with recurrent nasal inverted papilloma about 200 ml. Shorter operative time, minimal postoperative pain, epithelization of nasal cavity was seen 2 months postoperatively. There were no complications. All patients were followed-up for 2-6 months, with no recurrence.

CONCLUSIONSSurgical treatment of nasal inverted papilloma using low-temperature plasma radiofrequency had following advantages: less blood loss, complete en bloc tumor resection, mild injury, short surgery time, mild postoperative pain. In summary, low-temperature plasma radiofrequency is a minimally invasive treatment for nasal inverted papilloma.

Aged ; Aged, 80 and over ; Catheter Ablation ; methods ; Cold Temperature ; Debridement ; Endoscopy ; Female ; Humans ; Male ; Middle Aged ; Nose Neoplasms ; surgery ; Papilloma, Inverted ; surgery ; Retrospective Studies ; Treatment Outcome

OBJECTIVETo compare endoscopic approach with lateral rhinotomy for treatment of the sinonasal inverted papilloma in terms of advantage, indications and limitations of the procedures.

METHODSEighty-six cases with inverted papilloma were reviewed retrospectively, among which 23 cases underwent transnasal endoscopic procedures including 10 combined with Caldwell-Luc intervention, and 63 cases underwent lateral rhinotomy. The follow-up period ranged from 11 - 36 m (mean 23 m). The data were processed statistically by SPSS 10.0 software.

RESULTBoth procedures permitted removal of most sinonasal inverted papilloma. The endoscopic surgery provided an excellent visualization, and preserved a vital anatomic structure and left no facial scar. Lateral rhinotomy was associated with postoperative facial scar or deformity. The recurrence rate in lateral rhinotomy group was 9.5% and in endoscopic approach was 13% (P >0.05).

CONCLUSIONEndoscopic approach is favored for the treatment of non-massively extending sinonasal inverted papilloma because of an acceptable recurrence and a better cosmetic results.

Adolescent ; Adult ; Aged ; Endoscopy ; Female ; Humans ; Male ; Middle Aged ; Nose ; surgery ; Nose Neoplasms ; surgery ; Otorhinolaryngologic Surgical Procedures ; methods ; Papilloma, Inverted ; surgery ; Paranasal Sinus Neoplasms ; surgery ; Retrospective Studies ; Treatment Outcome

OBJECTIVE: To evaluate the prognosis of Draf II b surgery in treating fontal sinus inverted papilloma. METHOD: A retrospective study was carried out among 15 patients diagnosed as fontal sinus inverted papilloma, which had underwent endoscopic Draf II b surgery. The clinical success rate and surgical success rate were calculated by survival analysis. RESULT: In all patients, there were 1 (6.67%) recurrence,1 (6.67%) stenosis, 4 (26.67)% complete closure, and 1 (6.67%) mucocele cyst. The 3-year clinical success rate was 93.3%, and the 3-year surgical success rate was 65.0%. CONCLUSION Draf II b surgery is feasible when the frontal sinus inverted papilloma is involved in the area of the pupil center line, and the frontal neo-ostium stenosis or complete closure is a common complication after surgery. Thus a close follow-up is recommended during the first year after the surgery. Further study is necessary to find a better way to reduce the complication rate.
Constriction, Pathologic ; pathology ; Endoscopy ; Frontal Sinus ; pathology ; Humans ; Mucocele ; pathology ; Nasal Surgical Procedures ; methods ; Neoplasm Recurrence, Local ; Papilloma, Inverted ; surgery ; Paranasal Sinus Neoplasms ; surgery ; Postoperative Complications ; pathology ; Prognosis ; Retrospective Studies ; Survival Analysis ; Treatment Outcome