Clinical analysis of inverted papillomas of the nasal cavity and paranasal sinuses

Clinical analysis of inverted papillomas of the nasal cavity and paranasal sinuses. Objectives: To examine clinical parameters, therapeutic modalities, recurrences and HPV status in patients diagnosed with inverted papilloma of the nasal cavity and paranasal sinuses. Methods: In this study, 47 patients with inverted papillomas were analysed according to sex, age, symptoms, localization, T stage, preoperative imaging methods, surgery, complications, HPV status and recurrences. Results: A unilateral manifestation of inverted papilloma was detected in 95.7% of patients; the left side was more frequently affected (68%). The primary localization was the maxillary sinus (65.9%), followed by ethmoid cells (53.2%). Most patients had T3 tumours as per Krouse; 42 patients were treated by endoscopic endonasal surgery, four patients by a combined endo- and external approach and one patient via external surgical access. The complication rate was low (6.3%). In three patients, a malignant transformation occurred. One of these patients was HPV positive. The recurrence rate was 25.5%; patients with T4 papillomas had the highest recurrence rate, followed by patients with T3 tumours. Conclusion: Endonasal endoscopic resection of inverted papillomas of the nose and paranasal sinuses is feasible in the vast majority of cases and appears to be associated with low morbidity for patients. Recurrences most often occur in T3 and T4 papillomas.