The inverted papilloma as an incidential finding in sinus surgery

Introduction The Inverted Papilloma (IP) shows a recurrence rate of up to 25.3 %. Due to its aggressive growth and a possible malignant transformation, complete surgical removal is mandatory. The aim of the study was to analyse the postoperative outcome of patients with IP as well as to identify preoperative hints regarding the origin in computed tomography (CT).

Materials and methods All patients who were randomly diagnosed with IP in the period from 2007 to 2019 were included. Preoperative CT was analysed for typical IP characteristics, categorized according to Krouse classification, and postoperative outcome was compared.

Results 108 patient files were included. The maxillary sinus (58 %) and the middle and inferior turbinate (13 %) were the most frequent origins of the IP. In 70 %, CT showed a thickening of the bone at the origin of the papilloma, in a further 8 % osseous destruction was observed. In 12 cases the origin could not be exactly defined in the surgical report, however in all these cases a bone change in the CT appeared at the presumed place of origin. The most frequent recurrences occurred in the maxillary followed by the ethmoidal sinus.

Conclusion Recurrence in patients with IP is common. The accurate analysis of the preoperative CT allowed an identification of the origin in 78 %. If an IP is suspected, the CT should therefore be examined for bone changes, as this enables a more precise resection and can prevent recurrence.

Poster-PDF A-1352.PDF

Publication History

Article published online:
10 June 2020