Hildenbrand Tanja, Weber Rainer K
Klinik für Hals‑, Nasen- und Ohrenheilkunde, Universitätsklinikum Freiburg, Killianstr. 5, 79106, Freiburg, Deutschland.
Sektion Nasennebenhöhlen- und Schädelbasischirurgie, Traumatologie, Klinik für Hals‑, Nasen- und Ohrenheilkunde, Städtisches Klinikum Karlsruhe, Karlsruhe, Deutschland.
HNO. 2024 Apr;72(4):257-264. doi: 10.1007/s00106-023-01406-7. Epub 2024 Jan 12.
Inverted papilloma (IP) are benign tumors that show a locally aggressive behavior, a high rate of recurrence, and a potential for malignant transformation. Specific radiological signs such as hyperostosis at the origin of the IP and convoluted cerebriform patterns, as well as the typical endoscopic aspect, can lead to diagnosis and enable preoperative planning of surgical access and the extent of surgery. Endonasal endoscopic techniques are considered the gold standard and the introduction of extended surgical techniques such as the prelacrimal approach, frontal drillout, or orbital transposition facilitate complete subperiosteal resection with preservation of important physiological structures. There is a risk of synchronous and metachronous squamous cell carcinomas (IP-SCC). Research focuses on radiological criteria to differentiate benign IP from IP-SCC, genetic and epigenetic factors in the process of malignant transformation, and estimation of the risk of IP progressing to IP-SCC.
内翻性乳头状瘤(IP)是一种良性肿瘤,具有局部侵袭性、高复发率和恶变潜能。IP起源处的骨质增生和脑回状形态等特定影像学征象,以及典型的内镜表现,有助于诊断并能进行手术入路和手术范围的术前规划。鼻内镜技术被认为是金标准,而泪前入路、额部钻孔或眶部移位等扩展手术技术的引入,有助于在保留重要生理结构的情况下进行完整的骨膜下切除。存在同时性和异时性鳞状细胞癌(IP-SCC)的风险。研究重点在于区分良性IP与IP-SCC的影像学标准、恶变过程中的遗传和表观遗传因素,以及评估IP进展为IP-SCC的风险。