Article

Isolated Inverted Papilloma of the Sphenoid Sinus

Department of Otolaryngology-Head and Neck Surgery, Tri-Service General Hospital, National Defense Medical Center, 325 Cheng-Kung Road, Taipei, Taiwan.
Journal of the Chinese Medical Association (Impact Factor: 0.85). 09/2010; 73(9):503-5. DOI: 10.1016/S1726-4901(10)70108-8
Source: PubMed

ABSTRACT

Primary inverted papilloma of the sphenoid sinus is rare. Such a case, of a 42-year-old female, is reported here, discussing the clinical presentation, diagnostic clues, radiographic features, histological findings and management. In contrast to the vast majority of cases that present with nasal complaints because of lateral nasal wall involvement, the clinical presentation of inverted papillomas confined to the sphenoid sinus is often nonspecific and insidious. Nasal endoscopy and radiologic imaging are key to an accurate diagnosis. Preoperative imaging with computed tomography and the surgeon's experience will dictate the appropriate surgical approach. In our opinion, transnasal endoscopic large sphenoidotomy remains an effective modality for management of patients with this lesion when the sphenoid sinus is the only sinus requiring investigation. A more anatomically directed approach to the sphenoid sinus with less violation of other sinuses can be achieved.

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Available from: Jiann-Jy Chen, Nov 26, 2014
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    ABSTRACT: Primary inverted papilloma of the sphenoid sinus is rare. Such a case, of a 42-year-old female, is reported here, discussing the clinical presentation, diagnostic clues, radiographic features, histological findings and management. In contrast to the vast majority of cases that present with nasal complaints because of lateral nasal wall involvement, the clinical presentation of inverted papillomas confined to the sphenoid sinus is often nonspecific and insidious. Nasal endoscopy and radiologic imaging are key to an accurate diagnosis. Preoperative imaging with computed tomography and the surgeon's experience will dictate the appropriate surgical approach. In our opinion, transnasal endoscopic large sphenoidotomy remains an effective modality for management of patients with this lesion when the sphenoid sinus is the only sinus requiring investigation. A more anatomically directed approach to the sphenoid sinus with less violation of other sinuses can be achieved.
    Full-text · Article · Sep 2010 · Journal of the Chinese Medical Association
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    ABSTRACT: Isolated inverting papilloma (IP) of the sphenoid sinus is rare, with about 50 patients reported in the English-language literature. With its rarity, scientists have paid less attention to the clinical and radiographic characteristics of isolated IPs arising from the sphenoid sinus. We describe the clinical presentation, imaging manifestations, and surgical methods of isolated IPs from the sphenoid sinus in 3 patients and review the English-language literature from 1970 to 2011. In total, 59 cases of isolated sphenoid sinus IPs (including our cases) have been reported, 40 patients with computed tomography or magnetic resonance imaging details. The most common presentation is headache. Lesions were found in the sphenoethmoidal recess in 26 cases. In 8 patients who underwent enhanced magnetic resonance imaging, the tumor was obviously intensified. We found 26 patients with bony destruction, and 8 lesions revealed the correct tumor origin. A polyp-like mass in the sphenoethmoidal recess strongly implied the diagnosis of an IP in the sphenoid sinus. Bony destruction on computed tomography is a common characteristic of this disease and had a close relationship with the original tumor site in our study. Malignant transformation of IPs in the sphenoid sinus is much scarcer.
    No preview · Article · Jul 2012 · The Journal of craniofacial surgery
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    ABSTRACT: Objective: Inverted papilloma (IP) is a benign tumor of the sinonasal area. Surgical treatment is important due their recurrence and potential for the malignant transformation. The aim of this study is to analyze treatment methods of inverted papilloma according to the tumor stages and postoperative clinical outcomes (recurrence, and malignancy). Material and Methods: Thirty five patients diagnosed with sinonasal inverted papilloma in Kocaeli University Medical Faculty ENT clinic between 2005-2012 years are included in the study. Complaints at presentation and tumor characteristics (location, stage) of the patients were retrospectively reviewed from their files. Treatment modalities were analyzed according to the tumor characteristics and postoperative outcomes. Results: There were 27 males and 8 females with a mean age of 52.40 years (range 18?80 years). All patients were admitted to our hospital with the complaints of nasal obstruction. Postoperative mean follow up was 40.51 (5-84) months. According to the classification of Krouse, 20 patients (57.14%) were staged as T3, 13 patients (37.14%) were staged as T2, and 2 patients (5.71%) were staged as T1. Twenty eight patients (80.0%) underwent endoscopic sinus surgery. In 7 cases (20.0%) the tumor could not be seen completely and the procedure was combined with the Caldwell-Luc procedure. The tumor recurred in 5 patients (14.28%). Postoperative pathology was reported as squamous cell carcinoma in 2 patients with recurrence (5.71%). Conclusion: T1 and T2 inverted papillomas can be removed endoscopically. In T4 and T3 tumors, an external approach should be combined to obtain an adequate exposure.
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