Natallia MarozavaN. N. Alexandrov National Cancer Centre of Belarus, Republic of Belarus
Title: Surgical treatment of sinonasal inverted papilloma in Belarus
Research objective: Analysis of surgical treatment of sinonasal inverted papilloma using endoscopic techniques.
Introduction: Sinonasal inverted papilloma belongs to a rare group of Schneiderian papillomas — benign tumors deriving from the Schneiderian membrane — the embryonal ectodermal remnant forming the boundary between the nasal and sinus mucosa. The frequency of occurrence is 0.2 -1.5 per 100,000 people per year. Inverted papilloma is characterized by a high tendency to relapse (in 3 - 19% of cases) and malignancy (from 5 to 15%), therefore, the relevance of treatment of this pathology is beyond doubt. The treatment of choice is surgical; endoscopic endonasal approach has now become the gold standard for many authors.
Materials and methods: 35 patients with sinonasal inverted papilloma were operated during the period from 2018 to 2021 in N. N. Alexandrov National Cancer Centre of Belarus. Patients were classified according to Krouse staging. All patients were treated with endoscopic approach. Patients underwent endoscopic total ethmoidectomy, frontotomy of the Draf IIA type with removal of the frontoethmoid pocket cells, maxillectomy of type 3A, wide opening of the sphenoid sinus.
Results and discussions: The group was composed of 22 (62.9%) males and 13 (37.1%) females (ratio: 1.7:1); age ranged from 22 to 80 years (average: 54.8 years, standard deviation (SD) 13.81). The average duration of follow-up was 26,9 months (3-140 months, SD 27.79). During the current period, 6 (17,1%) patients of inverted papilloma with stage I, 4 (11,5%) with stage II, 20 (54,3%) with stage III, 6 (17,1%) with stage IV according to the Krouse classification were operated on. Complications (epistaxis) occurred in 1 (2.8 %) patients. Recurrence of the disease was found in 8 (22.9%) patients. Malignant transformation was detected in 6 (17.1%) patients. Inverted papilloma is a benign tumor with a high rate of recurrence and malignancy, requiring complete resection.