Otorhinolaryngology and Skull Base Center, AP-HP, Hospital Lariboisiere, Paris, France.
Unit of Otorhinolaryngology-Head and Neck Surgery, ASST Spedali Civili Brescia, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy.
Rhinology. 2023 Aug 1;61(4):368-375. doi: 10.4193/Rhin23.035.
Treatment of inverted papilloma of the maxillary sinus (IPMS) has a lower success rate compared to other IPs. As such, its correct management generally needs trans-nasal endoscopic medial maxillectomy (EMMs) for adequate resection. The aim of this manuscript is to describe outcomes and major prognostic factors of a cohort of patients with IPMS who were treated with EMM.
In this multicentric study, patients affected with IPMS and treated with EMMs were included. The site of origin of the IPMS were studied as well as the type of EMM performed. The histological features (IP vs dysplasia), type of mucosal resection (total vs. pedicle oriented), and post-operative complications were analyzed.
310 patients were included (212 primary and 98 recurrent cases). After a mean follow-up of 45.4 months, 15 patients experienced recurrence (4.8%) due to the application of EMMs tailored to the surgical insertion point. Dysplasia was significantly associated with a higher risk of recurrence. The rates of early and late complications were 11.6% and 11.9%, respectively.
IPMS resection via tailored EMM is associated with excellent disease control, thus excluding the systematic use of extended EMMs, which can however be justified in case of dysplastic IPMS given its significant impact on recurrence.
与其他部位的内翻性乳头状瘤（IP）相比，上颌窦内翻性乳头状瘤（IPMS）的治疗成功率较低。因此，通常需要经鼻内镜内侧上颌窦切除术（EMMs）进行充分切除以正确治疗。本文旨在描述一组接受 EMM 治疗的 IPMS 患者的结果和主要预后因素。
在这项多中心研究中，纳入了患有 IPMS 并接受 EMM 治疗的患者。研究了 IPMS 的起源部位以及所进行的 EMM 类型。分析了组织学特征（IP 与发育不良）、黏膜切除类型（全层 vs. 蒂部定向）和术后并发症。
共纳入 310 例患者（212 例原发性和 98 例复发性病例）。平均随访 45.4 个月后，由于应用了针对手术插入点定制的 EMM，15 例患者（4.8%）出现复发。发育不良与更高的复发风险显著相关。早期和晚期并发症的发生率分别为 11.6%和 11.9%。
通过定制 EMM 切除 IPMS 与良好的疾病控制相关，因此排除了广泛使用 EMM 的做法，但对于具有显著复发影响的发育不良性 IPMS 可以合理应用。
