Endoscopic surgery for inverted papilloma originating from the sphenoid sinus and related clinical characteristics.

Abstract

CONCLUSIONS: Bony changes on CT imaging of inverted papilloma (IP) are useful for predicting tumor origin and recurrence sites. Because the lateral wall and floor of the sphenoid sinus are the most common origin and recurrence sites, the anterior wall of the sphenoid sinus should be opened as wide as the lateral wall and inferiorly to the level of the floor, especially in deeply pneumatized sphenoid sinuses.

OBJECTIVES: The incidence of isolated sphenoid IP is exceedingly low. So far, there have not been studies on the usual origin and recurrence sites of the sphenoid sinus. We sought to identify the sites of origin and recurrence and describe clinical characteristics, radiological features, and proper endoscopic management.

PATIENTS AND METHODS: We retrospectively reviewed medical records of patients with IP of the sphenoid sinus. Data collection included clinical presentations, origin and recurrent sites, radiological features, and surgical methods.

RESULTS: Seven patients were identified. The most common symptoms were headache and nasal obstruction. Radiological findings showed that most tumors extended into the nasal cavity or ethmoid sinus combined frequently with erosion of the lateral wall or intersinus septum. We noted simultaneous attachment to multiple walls in five subjects, including both lateral wall and floor attachment in three subjects.