Clinical Features Of Sinonasal Inverted Papilloma With Recurrence And Malignant Transformation

Objective To investigate the clinical characteristics,treatment and theeffectiveness of sinonasal inverting papilloma with recurrenceand malignant transformation.Methods Retrospective comparative analysis of sinonasal invertingpapilloma with recurrence and malignant transformation treated from Jan.2008to Oct.2012in our hospital.Results All the24patients with recurrence had the history ofsinonasal surgery.Their age was31~73years old and the male to femaleratio was17:7. Among them,17patients recurred once,6recurred twice and1recurred three times.The recurrence time was from1month to14yearsafter operation.Among the24patients with recurrence,1received modifiedendoscopic Lothrop procedure,1Caldwell-Luc operation,1lateralrhinotomy,1extranasal incision combined with endoscope, the rest sufferedsinonasal surgery.4patients relapsed within half year after5months to4years follow-up and the recurrence ratio was16.7%(4/24). All the4patients with recurrence had an operation once again and one of them was given chemoradiotherapy after surgery whose pathological results showedcanceration.There was no recurrence among the all of24patients followedup until now.Among5patients with malignant transformation,1receivedextended sublabial incision combined with endoscope,1lateral rhinotomy,1modified endoscopic Lothrop extended resection,2simple sinonasaloperation.Three patients of them were given radiochemotherapy aftersurgery.Except1patient died of extensive recurrence,1received otheroperation after relapsed twice and1lost follow up,all the others were alivewithout recurrence during10months to4years.Conclusion The surgical treatment with completely and positively isthe firse choice and an effective management for sinonasal invertingpapilloma.To the patients with recurrence on many times and malignanttumors,post-operative radiation or chemotherapy should be consideredwhen needed.