The Clinical Analysis Of 32 Cases Of Nasal Inverted Papilloma

OBJECTIVE: To find out the clinical factors related to therelapse of nasal inverted papilloma (NIP) through a retrospectivereview of 32 patients with a diagnose of nasal inverted papilloma.MATERIALS AND METHODS: The present article provides areview of 32 patients with a diagnosis of NIP treated in ENTdepartment of the first affiliated hospital of Jilin Uniwersity from Sep2001 to Sep 2005. All cases have been confirmed by pathological test,among which 6 cases accompanied dysplasia. The study groupconsisted of 22 male and 10 female patients with an average age of 51years. They were divided into 4 stages according to NIP stagingsystem proposed by Krouse JH in 2000, with 7cases in stageâ… , 14 instageâ…¡, 11 in stageâ…¢, 0 in stageâ…£. Lateral rhinotomy was performedin 17 patients, among which 2 cases in stageâ… , 7 in stageâ…¡, 8 instageâ…¢. Endoscopic surgery was performed in 15 patients, amongwhich 5 cases in stageâ… , 7 in stageâ…¡, 3 in stageâ…¢, with 2 casesunited with Caldwell-Luc approach. The follow-up period rangedfrom 8 months to 5.4 years (mean, 2.5 years). The patients'hospitalization period with lateral rhinotomy ranged from 8 to 16 days,with an average of 12.2 days. The patients'hospitalization period withendoscopy approach ranged from 4 to 13 days, with an average of 9.5days. Compare the staging condition based on CT to that based onsurgery according to Krouse JH'staging system.RESULTS: Recurrences developed in five patients (15.6%) inall. Three of these recurrences (17.6%) happened after lateralrhinotomy. Two (13.3%) after endoscopic approach, with norecurrences observed in the two cases united with Caldwell-Lucapproach. No recurrences occued in stage â… , 2 recurrences (14.2%)occured in stageâ…¡, 3 (27.2%) in stage â…¢. We observed obviousdifference in hospitalization period between patients undergone lateralrhinotomy and endoscopic approach. But there is no difference instaging condition based on CT compared to that based on surgery afterstatistical calculation. Two recurrences occured in the cases presentingdysplasia (33.3%).CONCLUSIONS: Our data suggest that relapse is likely tooccur in patients of higher stages. Dysplasia has a close relationshipwith relapse. Endoscopic approach can be performed on selectedlesions with recurrence rates that are comparable to those of moreaggressive techniques. Sinonasal computer tomography (CT) will playan important role in staging the NIP lesions before surgery.