A Review of Inverted Papilloma at a Tertiary Centre: A Six-Year Experience

Chiun Kian Chai, Ing Ping Tang, Narayanan Prepageran

Department of Otorhinolaryngology, Faculty of Medicine, University Malaysia Sarawak, Kota Samarahan, Malaysia.
Department of Otorhinolaryngology, University of Malaya, Kuala Lumpur, Malaysia.

DOI: 10.4236/ijohns.2013.25034                

Abstract

Objectives: To evaluate the clinical presentation and treatment outcome of all patients treated for inverted papilloma at the University Malaya Medical Centre, Malaysia. Methods: A retrospective review of 22 patients with inverted papilloma, treated at our centre, from 1st January 2005 to 31st August 2011. The demographic data, clinical features, radiological findings, surgical procedures, recurrent rate and malignant transformation were assessed. Result: The commonest presentation was a unilateral nasal blockage, comprising 77.3% cases. A total of 19 patients had undergone endoscopic surgery while three patients had open surgery performed. The mean duration of the follow-up period was 30.5 months. Seven (31.7%) patients were detected of tumour recurrence during the entire course of follow-up. However, throughout the follow-up period, none had demonstrated malignant transformation. Conclusion: Endoscopic medial maxillectomy is a well-accepted approach in treating inverted papilloma. Nevertheless, open surgery still plays an important role in extensive diseases and in cases of malignancy. Unilateral nasal obstruction is the most important symptom. Repeated pre-operative biopsy or perhaps frozen section of intraoperative biopsies is necessary to avoid misdiagnosis. Krouse stage II disease showed the highest recurrent rate of 18.2%. Lifelong follow-up and emphasis on adherence is mandatory for early detection of recurrence and malignant transformation.

Keywords

Inverted Papilloma; Medial Maxillectomy; Endoscopic Surgery

Conflicts of Interest

The authors declare no conflicts of interest.

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