Treatment Outcomes of Sinonasal Inverted Papilloma at Maharat Nakhon Ratchasima Hospital: A 10-Year experience
Keywords:
อินเวอร์เต็ดแปปิลโลมา, การผ่าตัดโดยการส่องกล้องทางโพรงจมูก, การกลับเป็นซ้ำของตัวโรคAbstract
ABSTRACT
Background : Inverted papilloma is an uncommon neoplasm of the nasal cavity. Although it
is classified as a benign tumor, it is characterized by locally aggressive behavior and carries a risk of malignant transformation. Most patients are diagnosed and treated at a delayed stage, by which time the disease has already advanced, resulting in severe treatment-related complications.
Objective : To examine the treatment outcomes of sinonasal inverted papilloma at
Maharat Nakhon Ratchasima Hospital.
Methods : A retrospective descriptive study enrolled patients diagnosed with sinonasal
inverted papilloma. The data was collected between October 2015 to September 2024.
Results : A total of 82 patients were included, with a mean age of 53.15 ± 14.1 years.
The majority were male(65.5%), and the most common presenting symptom was unilateral nasal obstruction(85.4%). The most frequent tumor location was the maxillary sinus(46.3%), and most tumors were diagnosed at Krouse’s stage III(39.1%). The predominant surgical approach was endoscopic endonasal approach, performed in 68.3% of cases. Postoperative complications were rare, occurring in only 7.3% of patients. Synchronous malignancy was identified in 3 cases(3.7%). The average follow-up period after surgery was 39 months. Tumor recurrence occurred on average within 8 months postoperatively, with an overall recurrence rate of 39%. Tumor origin was found to be significantly associated with recurrence (p = 0.043).
Conclusion : Inverted papilloma is more common in males over the age of 40. Endoscopic
sinus surgery remains the standard and effective treatment approach. The site of tumor origin, particularly in the frontal recess is significantly associated with a higher risk of recurrence. Postoperative follow-up is essential and should be maintained for at least 2–3 years, with close monitoring during the first 8–24 months, which represents the peak period for recurrence.
Keywords : Inverted Papilloma, Endoscopic Endonasal Surgery, Recurrence Rate
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