Department of Otolaryngology-Head and Neck Surgery, Sheba Medical Center, Tel-Hashomer, Israel.
Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Otolaryngol Head Neck Surg. 2021 May;164(5):1116-1121. doi: 10.1177/0194599820964798. Epub 2020 Oct 13.
To evaluate the correlation between the ability to predict the attachment site of sinonasal inverted papilloma by computed tomography and the long-term surgical outcome.
Retrospective cohort study.
Five tertiary medical centers.
Study patients underwent attachment-oriented resection of inverted papilloma. The primary outcome was tumor recurrence.
Among 195 patients eligible for the study, focal hyperostosis was recognized on computed tomography in 65% (n = 127), in 71% of primary cases (n = 101), and in 50% of revision procedures (n = 26). There was a trend for a higher incidence of squamous cell carcinoma among the patients without detectable hyperostosis ( = .051). Location of hyperostosis coincided with the actual tumor attachment site in 114 patients (90%). Discordance between these parameters did not differ significantly ( = .463) between 11 primary and 2 revision cases. The overall rate of recurrence was 9.7% (n = 19), with a mean time to recurrence of 20 months (range, 7-96 months). The rate of recurrence did not correlate with any of the following: tumor stage, surgical approach, presence of squamous cell carcinoma, whether the surgery was primary or revision, and the presence or location of focal hyperostosis on computed tomography. Inverted papilloma recurred significantly more often (38.5%) when the intraoperative findings of the tumor attachment site did not match the location of hyperostosis observed on computed tomography (odds ratio, 6.5; 95% CI, 1.78-23.66).
Detectability of focal hyperostosis on preoperative computed tomography does not affect the long-term outcome of inverted papilloma resection.
评估鼻窦内翻性乳头状瘤 CT 预测附着部位的能力与长期手术结果之间的相关性。
回顾性队列研究。
五家三级医疗中心。
研究患者接受了针对附着部位的内翻性乳头状瘤切除术。主要结果是肿瘤复发。
在符合研究条件的 195 名患者中，65%（n=127）在 CT 上发现局灶性骨肥厚，71%（n=101）的原发性病例和 50%（n=26）的复发性手术发现了局灶性骨肥厚。在未检测到骨肥厚的患者中，鳞状细胞癌的发生率较高（=0.051）。在 114 名患者中，骨肥厚的位置与实际肿瘤附着部位相吻合（90%）。在 11 例原发性和 2 例复发性病例中，这些参数之间的差异无统计学意义（=0.463）。总的复发率为 9.7%（n=19），复发的平均时间为 20 个月（范围 7-96 个月）。复发率与以下任何因素均无相关性：肿瘤分期、手术方式、是否存在鳞状细胞癌、手术是原发性还是复发性、以及 CT 上是否存在局灶性骨肥厚及其位置。当术中肿瘤附着部位的发现与 CT 观察到的骨肥厚位置不匹配时，内翻性乳头状瘤的复发率显著更高（38.5%）（优势比，6.5；95%CI，1.78-23.66）。
术前 CT 上局灶性骨肥厚的可检测性并不影响内翻性乳头状瘤切除的长期结果。
