Different Endoscopic Surgical Strategies in the Management of Inverted Papilloma of the Sinonasal Tract: Experience with 47 Patients
Objective: To demonstrate the potentials and limitations of three different endoscopic procedures employed for treatment of inverted papilloma (IP) of the sinonasal tract. Study Design: Retrospective analysis of a cohort of patients treated at two University hospitals. Methods: From January 1992 to...
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| Veröffentlicht in: | The Laryngoscope 2004-02, Vol.114 (2), p.193-200 |
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| creator | Tomenzoli, Davide Castelnuovo, Paolo Pagella, Fabio Berlucchi, Marco Pianta, Luca Delù, Giovanni Maroldi, Roberto Nicolai, Piero |
| description | Objective: To demonstrate the potentials and limitations of three different endoscopic procedures employed for treatment of inverted papilloma (IP) of the sinonasal tract.
Study Design: Retrospective analysis of a cohort of patients treated at two University hospitals.
Methods: From January 1992 to June 2000, 47 patients with IP underwent endoscopic resection. Preoperative workup included multiple biopsies of the lesion and imaging evaluation by computed tomography or magnetic resonance imaging. Massive skull base erosion, intradural or intraorbital extension, extensive involvement of the frontal sinus, abundant scar tissue caused by previous surgery, or the concomitant presence of squamous cell carcinoma were considered absolute contraindications for a purely endoscopic approach. Three types of resection were used: ethmoidectomy with wide antrostomy and sphenoidotomy (type 1) for IPs confined to the middle meatus, medial maxillectomy with ethmoidectomy and sphenoidotomy (type 2) for IPs partially invading the maxillary sinus, and a Sturmann‐Canfield operation (type 3) for IPs involving the mucosa of the alveolar recess or of the anterolateral corner of the maxillary sinus. All patients were followed by periodic endoscopic evaluations.
Results: Type 1, 2, and 3 resections were performed in 26, 15, and 6 patients, respectively. No recurrences were observed after a mean follow‐up of 55 (range 30–132) months. One patient, who underwent a type 2 resection, developed a stenosis of the lacrimal pathways requiring endoscopic dacryocystorhinostomy.
Conclusions: Our experience confirms that endoscopic surgery is an effective and safe method of treatment for most IPs. The availability of different endoscopic techniques allows the entity of the dissection to be modulated in relation to the extent of disease. Strict application of selection criteria, meticulous use of subperiosteal dissection in the involved areas, and regular follow‐up evaluation are key elements for success. |
| doi_str_mv | 10.1097/00005537-200402000-00003 |
| format | Article |
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Study Design: Retrospective analysis of a cohort of patients treated at two University hospitals.
Methods: From January 1992 to June 2000, 47 patients with IP underwent endoscopic resection. Preoperative workup included multiple biopsies of the lesion and imaging evaluation by computed tomography or magnetic resonance imaging. Massive skull base erosion, intradural or intraorbital extension, extensive involvement of the frontal sinus, abundant scar tissue caused by previous surgery, or the concomitant presence of squamous cell carcinoma were considered absolute contraindications for a purely endoscopic approach. Three types of resection were used: ethmoidectomy with wide antrostomy and sphenoidotomy (type 1) for IPs confined to the middle meatus, medial maxillectomy with ethmoidectomy and sphenoidotomy (type 2) for IPs partially invading the maxillary sinus, and a Sturmann‐Canfield operation (type 3) for IPs involving the mucosa of the alveolar recess or of the anterolateral corner of the maxillary sinus. All patients were followed by periodic endoscopic evaluations.
Results: Type 1, 2, and 3 resections were performed in 26, 15, and 6 patients, respectively. No recurrences were observed after a mean follow‐up of 55 (range 30–132) months. One patient, who underwent a type 2 resection, developed a stenosis of the lacrimal pathways requiring endoscopic dacryocystorhinostomy.
Conclusions: Our experience confirms that endoscopic surgery is an effective and safe method of treatment for most IPs. The availability of different endoscopic techniques allows the entity of the dissection to be modulated in relation to the extent of disease. Strict application of selection criteria, meticulous use of subperiosteal dissection in the involved areas, and regular follow‐up evaluation are key elements for success.</description><identifier>ISSN: 0023-852X</identifier><identifier>EISSN: 1531-4995</identifier><identifier>DOI: 10.1097/00005537-200402000-00003</identifier><identifier>PMID: 14755188</identifier><identifier>CODEN: LARYA8</identifier><language>eng</language><publisher>Hoboken, NJ: John Wiley & Sons, Inc</publisher><subject>Adult ; Aged ; Biological and medical sciences ; Biopsy ; endoscopic sinus surgery ; Endoscopy ; Ethmoid Sinus - surgery ; Female ; Follow-Up Studies ; Humans ; Inverted papilloma ; Magnetic Resonance Imaging ; Male ; Maxillary Sinus - surgery ; Medical sciences ; Middle Aged ; Nose - surgery ; nose and paranasal sinuses ; Otorhinolaryngology. Stomatology ; Papilloma, Inverted - surgery ; Paranasal Sinus Neoplasms - surgery ; Sphenoid Sinus - surgery ; Tomography, X-Ray Computed</subject><ispartof>The Laryngoscope, 2004-02, Vol.114 (2), p.193-200</ispartof><rights>Copyright © 2004 The Triological Society</rights><rights>2004 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4403-66195eca7aa7c00a2dc875544d3250f021cbfa11736878e52bed515544d2947a3</citedby><cites>FETCH-LOGICAL-c4403-66195eca7aa7c00a2dc875544d3250f021cbfa11736878e52bed515544d2947a3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1097%2F00005537-200402000-00003$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1097%2F00005537-200402000-00003$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1417,27924,27925,45574,45575</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=15459039$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/14755188$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Tomenzoli, Davide</creatorcontrib><creatorcontrib>Castelnuovo, Paolo</creatorcontrib><creatorcontrib>Pagella, Fabio</creatorcontrib><creatorcontrib>Berlucchi, Marco</creatorcontrib><creatorcontrib>Pianta, Luca</creatorcontrib><creatorcontrib>Delù, Giovanni</creatorcontrib><creatorcontrib>Maroldi, Roberto</creatorcontrib><creatorcontrib>Nicolai, Piero</creatorcontrib><title>Different Endoscopic Surgical Strategies in the Management of Inverted Papilloma of the Sinonasal Tract: Experience with 47 Patients</title><title>The Laryngoscope</title><addtitle>The Laryngoscope</addtitle><description>Objective: To demonstrate the potentials and limitations of three different endoscopic procedures employed for treatment of inverted papilloma (IP) of the sinonasal tract.
Study Design: Retrospective analysis of a cohort of patients treated at two University hospitals.
Methods: From January 1992 to June 2000, 47 patients with IP underwent endoscopic resection. Preoperative workup included multiple biopsies of the lesion and imaging evaluation by computed tomography or magnetic resonance imaging. Massive skull base erosion, intradural or intraorbital extension, extensive involvement of the frontal sinus, abundant scar tissue caused by previous surgery, or the concomitant presence of squamous cell carcinoma were considered absolute contraindications for a purely endoscopic approach. Three types of resection were used: ethmoidectomy with wide antrostomy and sphenoidotomy (type 1) for IPs confined to the middle meatus, medial maxillectomy with ethmoidectomy and sphenoidotomy (type 2) for IPs partially invading the maxillary sinus, and a Sturmann‐Canfield operation (type 3) for IPs involving the mucosa of the alveolar recess or of the anterolateral corner of the maxillary sinus. All patients were followed by periodic endoscopic evaluations.
Results: Type 1, 2, and 3 resections were performed in 26, 15, and 6 patients, respectively. No recurrences were observed after a mean follow‐up of 55 (range 30–132) months. One patient, who underwent a type 2 resection, developed a stenosis of the lacrimal pathways requiring endoscopic dacryocystorhinostomy.
Conclusions: Our experience confirms that endoscopic surgery is an effective and safe method of treatment for most IPs. The availability of different endoscopic techniques allows the entity of the dissection to be modulated in relation to the extent of disease. Strict application of selection criteria, meticulous use of subperiosteal dissection in the involved areas, and regular follow‐up evaluation are key elements for success.</description><subject>Adult</subject><subject>Aged</subject><subject>Biological and medical sciences</subject><subject>Biopsy</subject><subject>endoscopic sinus surgery</subject><subject>Endoscopy</subject><subject>Ethmoid Sinus - surgery</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Humans</subject><subject>Inverted papilloma</subject><subject>Magnetic Resonance Imaging</subject><subject>Male</subject><subject>Maxillary Sinus - surgery</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Nose - surgery</subject><subject>nose and paranasal sinuses</subject><subject>Otorhinolaryngology. Stomatology</subject><subject>Papilloma, Inverted - surgery</subject><subject>Paranasal Sinus Neoplasms - surgery</subject><subject>Sphenoid Sinus - surgery</subject><subject>Tomography, X-Ray Computed</subject><issn>0023-852X</issn><issn>1531-4995</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2004</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkc1u1DAUhSMEokPhFZA3sAtcx3acsKs6Q1tpgMIUASvL49xMDYmT2h7a7nlwnM7QbvHClo6-c3x_soxQeEOhlm8hHSGYzAsADumCfJLYo2xGBaM5r2vxOJsBFCyvRPH9IHsWwk8AKpmAp9kB5VIIWlWz7M_cti16dJEsXDMEM4zWkNXWb6zRHVlFryNuLAZiHYmXSD5opzfYT4ahJWfuN_qIDTnXo-26odeTOnEr6wanQ8q48NrEd2RxM6K36AySaxsvCZfJFJMQw_PsSau7gC_272H29f3i4vg0X346OTs-WuaGc2B5WdJaoNFSa2kAdNGYKvXBecMKAS0U1KxbTVOTZSUrFMUaG0HvgKLmUrPD7PUud_TD1RZDVL0NBrtOOxy2QVVAOS-BJrDagcYPIXhs1ehtr_2toqCmDah_G1D3G7iTWLK-3P-xXffYPBj3I0_Aqz2gQxpx67UzNjxwgosaWJ24-Y67th3e_ncBann05UfqmdJJnerJdzE2RLy5j9H-lyolk0J9-3iiTj-vzotSzBVnfwHUFa-t</recordid><startdate>200402</startdate><enddate>200402</enddate><creator>Tomenzoli, Davide</creator><creator>Castelnuovo, Paolo</creator><creator>Pagella, Fabio</creator><creator>Berlucchi, Marco</creator><creator>Pianta, Luca</creator><creator>Delù, Giovanni</creator><creator>Maroldi, Roberto</creator><creator>Nicolai, Piero</creator><general>John Wiley & Sons, Inc</general><general>Wiley-Blackwell</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>8BM</scope></search><sort><creationdate>200402</creationdate><title>Different Endoscopic Surgical Strategies in the Management of Inverted Papilloma of the Sinonasal Tract: Experience with 47 Patients</title><author>Tomenzoli, Davide ; Castelnuovo, Paolo ; Pagella, Fabio ; Berlucchi, Marco ; Pianta, Luca ; Delù, Giovanni ; Maroldi, Roberto ; Nicolai, Piero</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4403-66195eca7aa7c00a2dc875544d3250f021cbfa11736878e52bed515544d2947a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2004</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Biological and medical sciences</topic><topic>Biopsy</topic><topic>endoscopic sinus surgery</topic><topic>Endoscopy</topic><topic>Ethmoid Sinus - surgery</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Humans</topic><topic>Inverted papilloma</topic><topic>Magnetic Resonance Imaging</topic><topic>Male</topic><topic>Maxillary Sinus - surgery</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Nose - surgery</topic><topic>nose and paranasal sinuses</topic><topic>Otorhinolaryngology. Stomatology</topic><topic>Papilloma, Inverted - surgery</topic><topic>Paranasal Sinus Neoplasms - surgery</topic><topic>Sphenoid Sinus - surgery</topic><topic>Tomography, X-Ray Computed</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Tomenzoli, Davide</creatorcontrib><creatorcontrib>Castelnuovo, Paolo</creatorcontrib><creatorcontrib>Pagella, Fabio</creatorcontrib><creatorcontrib>Berlucchi, Marco</creatorcontrib><creatorcontrib>Pianta, Luca</creatorcontrib><creatorcontrib>Delù, Giovanni</creatorcontrib><creatorcontrib>Maroldi, Roberto</creatorcontrib><creatorcontrib>Nicolai, Piero</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>ComDisDome</collection><jtitle>The Laryngoscope</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Tomenzoli, Davide</au><au>Castelnuovo, Paolo</au><au>Pagella, Fabio</au><au>Berlucchi, Marco</au><au>Pianta, Luca</au><au>Delù, Giovanni</au><au>Maroldi, Roberto</au><au>Nicolai, Piero</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Different Endoscopic Surgical Strategies in the Management of Inverted Papilloma of the Sinonasal Tract: Experience with 47 Patients</atitle><jtitle>The Laryngoscope</jtitle><addtitle>The Laryngoscope</addtitle><date>2004-02</date><risdate>2004</risdate><volume>114</volume><issue>2</issue><spage>193</spage><epage>200</epage><pages>193-200</pages><issn>0023-852X</issn><eissn>1531-4995</eissn><coden>LARYA8</coden><abstract>Objective: To demonstrate the potentials and limitations of three different endoscopic procedures employed for treatment of inverted papilloma (IP) of the sinonasal tract.
Study Design: Retrospective analysis of a cohort of patients treated at two University hospitals.
Methods: From January 1992 to June 2000, 47 patients with IP underwent endoscopic resection. Preoperative workup included multiple biopsies of the lesion and imaging evaluation by computed tomography or magnetic resonance imaging. Massive skull base erosion, intradural or intraorbital extension, extensive involvement of the frontal sinus, abundant scar tissue caused by previous surgery, or the concomitant presence of squamous cell carcinoma were considered absolute contraindications for a purely endoscopic approach. Three types of resection were used: ethmoidectomy with wide antrostomy and sphenoidotomy (type 1) for IPs confined to the middle meatus, medial maxillectomy with ethmoidectomy and sphenoidotomy (type 2) for IPs partially invading the maxillary sinus, and a Sturmann‐Canfield operation (type 3) for IPs involving the mucosa of the alveolar recess or of the anterolateral corner of the maxillary sinus. All patients were followed by periodic endoscopic evaluations.
Results: Type 1, 2, and 3 resections were performed in 26, 15, and 6 patients, respectively. No recurrences were observed after a mean follow‐up of 55 (range 30–132) months. One patient, who underwent a type 2 resection, developed a stenosis of the lacrimal pathways requiring endoscopic dacryocystorhinostomy.
Conclusions: Our experience confirms that endoscopic surgery is an effective and safe method of treatment for most IPs. The availability of different endoscopic techniques allows the entity of the dissection to be modulated in relation to the extent of disease. Strict application of selection criteria, meticulous use of subperiosteal dissection in the involved areas, and regular follow‐up evaluation are key elements for success.</abstract><cop>Hoboken, NJ</cop><pub>John Wiley & Sons, Inc</pub><pmid>14755188</pmid><doi>10.1097/00005537-200402000-00003</doi><tpages>8</tpages></addata></record> |
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| subjects | Adult Aged Biological and medical sciences Biopsy endoscopic sinus surgery Endoscopy Ethmoid Sinus - surgery Female Follow-Up Studies Humans Inverted papilloma Magnetic Resonance Imaging Male Maxillary Sinus - surgery Medical sciences Middle Aged Nose - surgery nose and paranasal sinuses Otorhinolaryngology. Stomatology Papilloma, Inverted - surgery Paranasal Sinus Neoplasms - surgery Sphenoid Sinus - surgery Tomography, X-Ray Computed |
| title | Different Endoscopic Surgical Strategies in the Management of Inverted Papilloma of the Sinonasal Tract: Experience with 47 Patients |
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