Endoscopic surgery for recurrent inverted papilloma. 2004

Ta-Jen Lee, and Shiang-Fu Huang, and Li-Ang Lee, and Chi-Che Huang
Department of Otolaryngology, Chang Gung Memorial Hospital, Taipei, Taiwan.

OBJECTIVE Inverted papilloma of the nose and paranasal sinuses is noted for its high rate of recurrence. The feasibility of endoscopic treatment for inverted papilloma has been shown in the literature; however, reports discussing the efficacy of endoscopic surgery for recurrent diseases are rare. The study determined the effectiveness of endoscopic surgery for recurrent inverted papilloma and described when endoscopic medial maxillectomy was indicated. METHODS Retrospective. METHODS Seventeen patients with recurrent inverted papilloma were treated over a 10-year period. Krouse's staging system was used for tumor grading. Because of the extent of the tumor in the majority (70.6%) of the patients, en bloc resection could not be regularly achieved; therefore, sequential segmental endoscopic surgery was the chosen treatment. Some diseases that extensively involved the maxillary sinus were treated by the combination of endoscopic medial maxillectomy (EMM) and sequential segmental surgery (SSES) to extirpate the whole disease. RESULTS Efficacy was evaluated strictly by radiographic study. Successful treatment was accomplished in 14 (82.4%) patients. Three (17.6%) patients had residual disease; each required one revision surgery. None of the patients had recurrence at the time of writing. There were no major complications or associated malignancies encountered in the patients. CONCLUSIONS Endoscopic surgery is an effective treatment for recurrent inverted papilloma. Precise determination of the sites of tumor origin and attachment during the operation is the key to the successful treatment. Recurrent inverted papilloma tends to behave more aggressively and has a higher postoperative recurrence rate than the primary lesion. Stage III disease had a higher recurrence rate (27.3%) than that of other stages (0%).

UI MeSH Term Description Entries
D008279 Magnetic Resonance Imaging Non-invasive method of demonstrating internal anatomy based on the principle that atomic nuclei in a strong magnetic field absorb pulses of radiofrequency energy and emit them as radiowaves which can be reconstructed into computerized images. The concept includes proton spin tomographic techniques. Chemical Shift Imaging,MR Tomography,MRI Scans,MRI, Functional,Magnetic Resonance Image,Magnetic Resonance Imaging, Functional,Magnetization Transfer Contrast Imaging,NMR Imaging,NMR Tomography,Tomography, NMR,Tomography, Proton Spin,fMRI,Functional Magnetic Resonance Imaging,Imaging, Chemical Shift,Proton Spin Tomography,Spin Echo Imaging,Steady-State Free Precession MRI,Tomography, MR,Zeugmatography,Chemical Shift Imagings,Echo Imaging, Spin,Echo Imagings, Spin,Functional MRI,Functional MRIs,Image, Magnetic Resonance,Imaging, Magnetic Resonance,Imaging, NMR,Imaging, Spin Echo,Imagings, Chemical Shift,Imagings, Spin Echo,MRI Scan,MRIs, Functional,Magnetic Resonance Images,Resonance Image, Magnetic,Scan, MRI,Scans, MRI,Shift Imaging, Chemical,Shift Imagings, Chemical,Spin Echo Imagings,Steady State Free Precession MRI
D008297 Male Males
D008443 Maxillary Sinus The air space located in the body of the MAXILLARY BONE near each cheek. Each maxillary sinus communicates with the middle passage (meatus) of the NASAL CAVITY on the same side. Antrum of Highmore,Maxillary Antrum,Maxillary Ostium,Antrum, Maxillary,Highmore Antrum,Maxillary Antrums,Maxillary Ostiums,Sinus, Maxillary
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D009364 Neoplasm Recurrence, Local The local recurrence of a neoplasm following treatment. It arises from microscopic cells of the original neoplasm that have escaped therapeutic intervention and later become clinically visible at the original site. Local Neoplasm Recurrence,Local Neoplasm Recurrences,Locoregional Neoplasm Recurrence,Neoplasm Recurrence, Locoregional,Neoplasm Recurrences, Local,Recurrence, Local Neoplasm,Recurrence, Locoregional Neoplasm,Recurrences, Local Neoplasm,Locoregional Neoplasm Recurrences,Neoplasm Recurrences, Locoregional,Recurrences, Locoregional Neoplasm
D009367 Neoplasm Staging Methods which attempt to express in replicable terms the extent of the neoplasm in the patient. Cancer Staging,Staging, Neoplasm,Tumor Staging,TNM Classification,TNM Staging,TNM Staging System,Classification, TNM,Classifications, TNM,Staging System, TNM,Staging Systems, TNM,Staging, Cancer,Staging, TNM,Staging, Tumor,System, TNM Staging,Systems, TNM Staging,TNM Classifications,TNM Staging Systems
D009669 Nose Neoplasms Tumors or cancer of the NOSE. Cancer of Nose,Nasal Neoplasms,Nose Cancer,Cancer of the Nose,Nasal Cancer,Neoplasms, Nose,Cancer, Nasal,Cancer, Nose,Cancers, Nasal,Cancers, Nose,Nasal Cancers,Nasal Neoplasm,Neoplasm, Nasal,Neoplasm, Nose,Neoplasms, Nasal,Nose Cancers,Nose Neoplasm
D010255 Paranasal Sinus Neoplasms Tumors or cancer of the PARANASAL SINUSES. Cancer of Paranasal Sinus,Neoplasms, Paranasal Sinus,Paranasal Sinus Cancer,Cancer, Paranasal Sinus,Cancers, Paranasal Sinus,Neoplasm, Paranasal Sinus,Paranasal Sinus Cancers,Paranasal Sinus Neoplasm
D010256 Paranasal Sinuses Air-filled spaces located within the bones around the NASAL CAVITY. They are extensions of the nasal cavity and lined by the ciliated NASAL MUCOSA. Each sinus is named for the cranial bone in which it is located, such as the ETHMOID SINUS; the FRONTAL SINUS; the MAXILLARY SINUS; and the SPHENOID SINUS. Nasal Sinuses,Osteomeatal Complex,Ostiomeatal Complex,Ostiomeatal Unit,Sinonasal Tract,Supraorbital Ethmoid Cell,Cell, Supraorbital Ethmoid,Complex, Osteomeatal,Ethmoid Cell, Supraorbital,Osteomeatal Complices,Ostiomeatal Complices,Ostiomeatal Units,Sinonasal Tracts,Sinuses, Nasal,Supraorbital Ethmoid Cells,Tract, Sinonasal
D004724 Endoscopy Procedures of applying ENDOSCOPES for disease diagnosis and treatment. Endoscopy involves passing an optical instrument through a small incision in the skin i.e., percutaneous; or through a natural orifice and along natural body pathways such as the digestive tract; and/or through an incision in the wall of a tubular structure or organ, i.e. transluminal, to examine or perform surgery on the interior parts of the body. Endoscopic Surgical Procedures,Surgical Procedures, Endoscopic,Endoscopic Surgical Procedure,Endoscopy, Surgical,Surgical Endoscopy,Surgical Procedure, Endoscopic,Procedure, Endoscopic Surgical,Procedures, Endoscopic Surgical

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