Department of Otolaryngology/Head and Neck Surgery, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Spain.
Am J Rhinol Allergy. 2010 Jan-Feb;24(1):66-9. doi: 10.2500/ajra.2010.24.3421.
The aim of this study was to describe treatment results in patients with sinonasal inverted papilloma and to compare recent classification staging systems.
We performed a retrospective study of 79 patients with primary paranasal sinus inverted papilloma from 1978 to 2008.
The median age at diagnosis was 59 years. There were 68 men (86%) and 11 women (14%). Sixty inverted papilloma (76%) were located in the ethmoidal sinus complex, 16 (20%) were in the maxillary sinus, 2 were in the sphenoid sinus (3%), and 1 was in the septum (1%). Malignancy was simultaneously associated in four cases (5%). Intracranial extension was found in five patients (6%) and we did not find orbital content involvement. The external approach was used in 22 cases (28%) and 57 patients were treated with endoscopic nasal resection (72%). The overall recurrence rate in the total population was 21%. Recurrences were observed in 7 cases (32%) in the group of patients who received external approach and in 10 (17%) patients in the endoscopic group. Recurrences according to the Krouse system were 0% in T1 stage, 16% in T2 stage, 25% in T3 stage, and 60% in T4 stage (p = 0.05). Recurrences for groups A, B, and C stages using the Cannady staging system were 12, 26, and 60%, respectively (p = 0.039). Recurrences according to Han's system were 19% in both T1 and T2, 20% in T3, and 60% in T4 (p > 0.05).
Our results support the endoscopic approach as the treatment of choice when feasible in patients with inverted papilloma, combined in selected cases with external approaches. The Krouse and Cannady systems provided a good distribution of patients according to local control.
本研究旨在描述鼻-鼻窦内翻性乳头状瘤患者的治疗结果，并对最近的分类分期系统进行比较。
我们对 1978 年至 2008 年间的 79 例原发性鼻窦内翻性乳头状瘤患者进行了回顾性研究。
诊断时的中位年龄为 59 岁。68 例为男性（86%），11 例为女性（14%）。60 例内翻性乳头状瘤（76%）位于筛窦复合体，16 例（20%）位于上颌窦，2 例位于蝶窦（3%），1 例位于鼻中隔（1%）。4 例（5%）同时合并恶性肿瘤。5 例患者（6%）出现颅内延伸，未发现眶内容物受累。22 例（28%）采用外入路，57 例（72%）采用内镜下鼻腔切除术。总人群的总体复发率为 21%。在外入路组中，7 例（32%）和内镜组中 10 例（17%）观察到复发。Krouse 分期系统中 T1 期无复发（0%），T2 期复发率为 16%，T3 期为 25%，T4 期为 60%（p=0.05）。Cannady 分期系统中 A、B 和 C 期的复发率分别为 12%、26%和 60%（p=0.039）。Han 系统中 T1 和 T2 期的复发率均为 19%，T3 期为 20%，T4 期为 60%（p>0.05）。
我们的结果支持在内翻性乳头状瘤患者中可行的情况下采用内镜治疗方法作为首选，并在某些情况下结合外入路。Krouse 和 Cannady 系统根据局部控制情况为患者提供了良好的分组。
