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CC BY 4.0 · Int Arch Otorhinolaryngol
DOI: 10.1055/s-0044-1785206
Original Research

Risk Factors for Recurrence after Surgical Resection of Sinonasal Inverted Papilloma

Eugénie Delaine 
1   Department of Ear, Nose, and Throat, Hopital du Valais, Sion, Switzerland
,
François Gorostidi
2   Department of Otorhinolaryngology and Head and Neck Surgery, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland
,
Pierre Guilcher
2   Department of Otorhinolaryngology and Head and Neck Surgery, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland
,
Karma Lambercy
2   Department of Otorhinolaryngology and Head and Neck Surgery, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland
,
Yann Litzistorf
2   Department of Otorhinolaryngology and Head and Neck Surgery, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland
,
Luc Bron
2   Department of Otorhinolaryngology and Head and Neck Surgery, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland
,
Antoine Reinhard
2   Department of Otorhinolaryngology and Head and Neck Surgery, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland
› Author Affiliations Funding The authors declare that they have received no funding from agencies in the public, private or non-profit sectors for the conduction of the present study.
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Abstract

Introduction Sinonasal inverted papilloma (SNIP) is a rare benign epithelial tumor of the nasal cavity and paranasal sinuses that accounts for 0.4% and 4.7% respectively, of all tumors of this anatomical region.

Objective To analyze the outcomes after surgical resection of SNIP and identify the risk factors for recurrence in a Swiss tertiary center.

Methods We conducted a retrospective review of all cases of SNIP treated at the Lausanne university hospital between 2005 and 2018. All data available on the patients and tumors were collected for analysis. We studied the recurrence rate and looked for risk factors.

Results We included 57 patients with a mean age of 55.5 years. There were 46 primary cases (80.7%) and 11 recurrences (19.3%). Maxillary sinus was the most frequent location (33.3%). Approximately half of the patients (52.6%) presented with a T3 tumor according to the Krouse classification. The mean recurrence rate after surgery was of 17.5% and it was more frequent among the patients in the recurrence group (45.5%) than among the primary cases (10.9%), reaching statistical significance (odds ratio [OR] = 6.8; 95% confidence interval [95%CI]: 1.5–30.8; p = 0.0165). Most patients were treated endoscopically (94.7%). Frontal sinus location, higher Krouse stage, and combined approach seemed to increase the risk of recurrence, but without statistical significance.

Conclusion Difficult surgical access, as in the case of tumors located in the frontal sinus, higher stage of the disease, and previously operated cases carry the higher risk of incomplete resection and recurrence.

Keywords

sinonasal inverted papilloma - Schneiderian papilloma - recurrence - endoscopic resection - Krouse classification


Publication History

Received: 12 October 2022

Accepted: 30 January 2024

Article published online:
25 May 2024

© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/)

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