원발 및 재발한 내장성 유두종의 치료성적 : 96예의 분석

Abstract

Background and Objectives：Inverting papilloma is a relatively uncommon sinonasal lesion of uncertain etiology and pathogenesis. This series was undertaken to investigate the incidence of associated polyps and the recurrence rates of inverting papillomas with or without malignancies, as well as the surgical outcomes of the recurred cases.

Materials and Methods：A retrospective study was conducted on 96 patients diagnosed with inverting papilloma between 1988 and 1998 on the evaluation of pathology, associated polyps, types of operation, recurrence rate after original operation, and surgical outcomes of recurred cases. Only histologically proven cases of inverting papilloma were included in this study. The follow-up period ranged from 24 to 72 months.

Results：The overall malignancy rate was 11.5% (11 cases), with synchronous tumors accounting for 9.4% (9 cases) and metachronous tumors accounting for 2.1% (2 cases). Inflammatory polyps were found in association with inverting papilloma in 21 cases (21.9%). For cases without malignancies, the overall recurrence rate after the original surgical procedure and the conservative procedure was 27.6% and 33.9%, respectively, whereas as, it was 14.3% after a medial maxillectomy. In cases with malignancies, the recurrence rate after the original surgical procedure was 22.2% (2 of 9 cases).

Conclusions：Our study indicates that irregularly surfaced polyps or mucosae during ethmoidectomy and polypectomy should be confirmed by tissue biopsy, and that more aggressive and bolder surgical resection of inverting papilloma should be undertaken as a primary treatment method, or as a treatment for recurring cases to reduce the recurrence rate of inverting papilloma, with or without malignancy.