Clinical characteristics of recurrent sinunasal inverted papilloma

Inverted papillomas (IP) are benign neoplasms of the nose and the paranasal sinuses. Peculiarity of this entity are possible malign transformation and destructive behaviour. Reported risk of recurrence is high. Aim of the following study was a characterization of recurrent IP. A gain of information to prevent recurrence and following burden of recurring surgical interventions is needed.

Methods A retrospective analysis of 108 patients with histological diagnosed IP between 2006 and 2019 was performed. 33 of 108 patients presented with recurrence of IP detected by case history, endoscopy and CT.

Results 33 patients (55% male, 45% female) with recurrent IP were characterized. 52% of recurrent IP were localized in the maxillary sinus and 20% in the ethmoidal sinus. Time to recurrence was between 2 and 216 months. In 39% of the patients recurrence was diagnosed within the first year after primary therapy. In 29% of patients time to recurrence was between 13 and 60 months. 32 of 33 patients with recurrent IP could be evaluated concerning technique of surgery. 28% of patients suffered from recurrent IP after endonasal surgery. 25% of patients who had undergone an open surgery suffered from recurrence. Recurrence occurred in 8% of patients after a combined technique of surgery. Recurrence free survival 24 months after surgery ranged above 80% within all patients who had undergone a surgical resection. 9 of 33 patients suffered from a second recurrence.

Conclusion  Recurrence period is distinct and can last up to several years. Endonasal resection is state of the art in therapy of recurrent IP. Respecting recurrence rate and morbidity, advantages of endonasal surgery are predominant. Consequent follow-up and precise resection are needed to enhance treatment success of recurrent IP.

Publication History

Article published online:
12 May 2023