Main Article Content
Objective: Sinonasal inverted papilloma (SNIP) is the most common nasal benign tumor, but locally invasive. The standard treatment is to identify origins of the tumor and total removal. Unfavourable results are finding postoperative residual or recurrent tumors. The aim of this study is to determine factors affecting postoperative residual or recurrent tumors and a rate of getting postoperative residual or recurrent tumors from SNIP surgeries.
Methods: A retrospective study in patients with SNIPs was conducted. Relationships between demographic data, tumor sites, tumor stages by Krouse classification, surgical approaches, surgeons’ experience, using microdebrider assisted surgery, operative time, intraoperative blood loss, histopathology, Epstein Barr virus (EBV), human papillomavirus (HPV) infection, time to detect tumor after surgery and unfavourable results were evaluated. HPV and EBV were detected by in situ hybridization.
Results: 73 patients were included in this study. Unfavourable results were found in 27 patients (36.99%). 50% of patients received unfavourable results after postoperative duration of 115 months. 5 years of a disease-free survival rate was 64.3% (95% CI: 51.9% to 76.7%). The patients with external surgical approaches got worse results than those with endoscopic sinus surgery (p = 0.01, a hazard ratio of 3.88, 95% CI: 1.39 to 10.87). The patients operated without using microdebrider assisted surgery got worse results than those with using the device (p < 0.001, an adjusted hazard ratio of 5.09, 95% CI: 2.08 to 12.45). The patients with abnormal pathological changes (tissue dysplasia and malignant transformation) had worse results than those without changes (p = 0.02, an adjusted hazard ratio of 3.42, 95% CI: 1.24 to 9.38).
Conclusion: Non-endoscopic nasal surgery, non-using microdebrider assisted surgery, and abnormal pathological changes may be some of the causes of unfavourable results from SNIP surgeries. Long postsurgical surveillance should be done, because of 36.99% of patients received unfavourable results from SNIP surgeries.
All articles published in the Siriraj Medical Journal (SMJ) are protected by copyright. No material in this journal may be reproduced on any platform including electronic or in print or transmitted by any means, in whole or in part, without the prior written permission of the Editor of the SMJ. Written permission must also be obtained before any part of the SMJ is stored in any retrieval system of any nature.
2. Lisan Q, Laccourreye O, Biofils P. Sinonasal inverted papilloma: from diagnosis to treatment. Eur Ann Otorhinolaryngol Head and Neck 2016; 113:337-341.
3. Hyams VJ. Papillomas of the nasal cavity and paranasal sinuses: a clinicopathologic study of 315 cases. Ann Otol Rhinol Laryngol 1971;80: 192-206.
4. Myers EN, Fernau JL, Johnson JT, Tabet JC, Barnes EL. Management of inverted papilloma. Laryngoscope 1990;100: 481-90.
5. Suh KW, Facer GW, Devine KD, Weiland LH, Zujko RD. Inverted papilloma of the nose and paranasal sinuses. Laryngoscope 1977;87: 35- 46.
6. Phillips PP, Gustafson RO, Facer GW. The clinical behavior of inverted papilloma of the nose and paranasal sinuses: report of 112 cases and review of the literature. Laryngoscope 1990; 100:463-9.
7. Sham CL, Woo JK, van Hasselt CA. Endoscopic resection of inverted papilloma of the nose and paranasal sinuses. J Laryngol Otol 1998; 112:758-64.
8. Busquets J M,Hwang P H. Endoscopic resection of sinonasal inverted papilloma: A meta-analysis. Otolaryngology -- Head and Neck Surgery 2006; 134: 476-82.
9. Peng R, Thamboo A, Choby G, Ma Y, Zhou B, Hwang P. Outcome of sinonasal inverted papilloma resection by surgical approach: an updated systematic review and meta-analysis. Int Forum Allergy Rhinol 2019; 9:573-81.
10. Adriaensen G, Lim K, Georgalas C, Reinartz S, Fokkens W. Challenges in the management of inverted papilloma: a review of 72 revision cases. Laryngoscope 2016;126:322-8.
11. Mirza S, Bradley P J, Acharya A, Stacey M, Jones N S. Sinonasal inverted papillomas: recurrence, and synchronous and metachronous malignancy. J Laryngol Otol 2007; 121: 857-64.
12. Anari S, Carrie S. Sinonasal inverted papilloma: narrative review. J Laryngol Otol 2010;124:707-15.
13. Xiao-Ting W, Peng Li, Xiu-Qing W, Hai-Bo W, Wen-Hui P, Bing LI, et al. Factors affecting recurrence of sinonasal inverted papilloma. Eur Arch Otorhinolaryngol 2013;270:1349-53.
14. Krouse JH. Endoscopic treatment of inverted papilloma: safety and efficacy. Am J Otolaryngol 2001; 22: 87-99.
15. Wang M, Noel J. Etiology of sinonasal inverted papilloma: a narrative review. World J Otorhinolaryngol Head Neck Surg 2017;3:54-58.
16. Sun Q, An L, Zheng J, Zhu D. Advances in recurrence and malignant transformation of sinonasal inverted papillomas (review). Oncology Letters 2017;13:4585-92.
17. Marchese D, Aleo G, Fulco G, Speciale R. Sinonasal inverted papilloma: factors affecting recurrence. Euromed Biomed J 2015;10:262-5.
18. Fooanant S, Pattarasukulchai T,Tananuvat R, Sittitrai P, Chaiyasate S, Roongrotwattanasiri K, et al. Sinonasal papilloma in Chiang Mai University Hospital. J Med Assoc Thai 2013;96:329-33.
19. McGarry G, Gana P, Adamson B. The effect of microdebriders on tissue for histological diagnosis. Clin Otolaryngol Allied Sci 1997;22:375-6.
20. Jardine A, Davies G, Birchall M. Recurrence and malignant degeneration of 89 cases of inverted papilloma diagnosed in a non-tertiary referral population between 1975 and 1995: clinical predictors and p53 studies. Clin Otolaryngol Allied Sci 2000;25: 363-9.
21. Syrjanen K, Syrjanen S. Detecting of human papilloma virus in sinonasal papillomas: systematic review and meta-analysis. Laryngoscope 2013;123:181-92.
22. Cornet M, Reinartz S,Geogalas C. The microdebrider, a step forward or an expensive gadget. Rhinology 2012;50:191-8.
23. Lawson W, Schlecht N, Gensler B. The role of the human papillomavirus in the pathogenesis of Schneiderian inverted papilloma: an analytic overview of the evidence. Head and Neck Pathol 2008;2:49-59.
24. Zhao R, Guo Z, Zhang R. Human papillomavirus infection and the malignant transformation of sinonasal inverted papilloma: a meta-analysis. J Clin Virol 2016; 79:36-43.
25. Pongsapich W, Eakkasem N, Siritantikorn S, Pithuksurachai P, Bongsabhikul K, Chongkolwatana C. Prevalence of HPV infection in hypopharyngeal and laryngeal squamous cell carcinoma at Thailand’s largest tertiary referral center. Infect Agent Cancer 2017;12:1-5.
26. Pongsapich W, Jotikaprasardhna P, Lianbanchong C, Phumchan A, Siritantikorn S, Chongkolwatana C. Human papillomavirus infection in oral cavity and oropharyngeal cancers: are they the same story?. J Med Assoc Thai 2016;99:684-90.
27. Phusingha P, Ekalaksananan T, Vatanasapt P, Loyha K, Promthet S, Kongyingyoes
B, et al. Human papillomavirus (HPV) infection in a case-control study of oral squamous cell carcinoma and its increasing trend in northeastern Thailand. J Med Virol 2017;89:1096-101.
28. Potaporn M, Apipan P, Suphanpayak S. Prevalence of human papillomavirus 16&18 in oral cavity and oropharyngeal squamous cell carcinoma in Rajavithi Hospital. J Med Assoc Thai 2018;101(Suppl 2):S1-S8.
29. Chotipanich A, Siriarechakul S, Mungkung O. Role of high-risk human papillomavirus in the etiology of oral and oropharyngeal cancers in Thailand: A case-control study. SAGE Open Med 2018;6:1-8.
30. Bishop J, Ma X, Wang H, Luo Y, Illei P, Begum S, et al. Detection of transcriptionally active high-risk HPV in patients with head and neck squamous cell carcinoma as visualized by a novel E6/E7 mRNA in situ hybridization method. Am J Surg Pathol 2012;36:1874-82.
31. Lee J, Shin J, Kim J, Choi Y, Lee K, Park J, et al. Evaluation of the HPV ISH assay in cervical cancer. Korean J Pathol 2010; 44: 513-20.
32. Kelesidis T, Aish L, Steller M, Aish I, Shen J, Foukas P, et al. Human papillomavirus (HPV) detection using in situ hybridization in histologic samples: correlations with cytologic changes and polymerase chain reaction HPV detection. Am J Clin Pathol 2011;136:119-27.
33. Govindaraj S, Wang H. Does human papilloma virus play a role in sinonasal inverted papilloma? Curr Opin Otolaryngol Head Neck Surg 2014; 22: 47-51.
34. Gloghini A, Volpi C, Gualeni A, Cortelazzi B, Perrone F, Pilotti S. Defining the better algorithm for the accurate identification of HPV status among oropharyngeal squamous-cell carcinoma. Results from a pilot study. World Can Res J 2015;2:1-5.
35. Schache A, Liloglou T, Risk J. Evaluation of human papilloma virus diagnostic testing in Oropharyngeal squamous cell carcinoma: senstivity specificity and prognostic discrimination. Clin Cancer Res 2011;17:6262-71.
36. Holte A, Fangk I, Glombitza S, Wilkens L, Welkoborsky H. Prognostic factors and risk factors for development and recurrence of sinonasal papillomas: potential role of different HPV subtypes. Eur Arch Otorhinolaryngol 2019 Dec 12 [Epub ahead of print].
37. Jareoncharsri P, Assanasen P, Chongkolwatana C, Metheetrairut C. Inverted papilloma at Siriraj Hospital. J Inter Coll Surg (Thailand) 1996;39:19-25.
38. Sbrana M, Borges R, Pinna F, Neto D, Voegels R. Sinonasal inverted papilloma: rate of recurrence and malignant transformation in 44 operated patients. Braz J Otorhinolaryngol 2019 Aug 12 [Epub ahead of print].
39. Healy D, Chhabra N, Metson R, Holbrook E, Gray S. Surgical risk factors for recurrence of inverted papilloma. Laryngoscope 2016;126:796-801.
40. Mak W, Webb D, Al-Salihi S, Dadgostar A, Javer A. Sinonasal inverted papilloma recurrence rates and evaluation of current staging systems. Rhinology 2018;56:407-14.
41. Thongyai K, Metheetrairut C. Midfacial degloving surgical approach: experience at Siriraj Hospital. J Med Assoc Thai 2003;86:1024-32.
42. Safadi A, Yafit D, Abu-Ghanem S, Ungar O, Wengier A, Abugel A, et al. The clinical behavior of sinonasal inverted papilloma with cellular dysplasia: case series and review literature. Eur Arch Otorhinolaryngol 2017;274:3375-82.