Sinonasal Papillomas in a Private Referral Otorhinolaryngology Centre: Review of 22 Years Experience

Publication date: September–October 2017
Source:Acta Otorrinolaringologica (English Edition), Volume 68, Issue 5
Author(s): Aderito de Sousa Fontes, Minaret Sandrea Jiménez, Nelson Urdaneta Lafée, Perfecto A. Abreu Durán, Liwven E. Quintana Páez, Andreina Carmina de Sousa de Abreu
ObjectivesTo evaluate the clinical presentation, treatment outcome and follow-up of all patients managed with sinonasal papillomas (SP), at a tertiary private otorhinolaryngology centre in Caracas (Venezuela).Material and methodsWe reviewed 94 patients with SP that were treated at our otolaryngology centre, from July 1st 1993 to June 31st 2015. The demographic data, clinical features, radiological findings, anatomical origin, disease extension into the adjacent structures, surgical approaches performed, histopathology outcomes, recurrent risk, malignant transformation rate and coadjuvant therapies were assessed.ResultsSixty-five patients (69.1%) were male and 29 (30.9%) female with an average age of 44.5 years (range 9–80 years). All patients underwent endoscopic sinus surgery. The most commont histologic subtypes of SP were inverted papilloma (58 patients; 61.7%), fungiform papilloma (35 patients; 37.2%) and oncocytic papilloma (one patient; 1.1%). SP was associated in 2 patients with undifferentiated squamous cell carcinoma. Twelve patients (12.8%) had disease with extension beyond the sinus without associated malignancy. All these patients received adjuvant treatment with advanced techniques of radiotherapy. The mean duration of the follow-up period was 9 years and 2 months. Eighteen patients (19.1%) had recurrent disease during the entire course of follow-up.ConclusionsComplete endoscopic surgical removal of SP is the treatment of choice. In less endoscopically accessible tumours, with peripheral extension or incompletely resected, Intensity Modulated Radiotherapy and Volumetric Modulated Arc Therapy may be indicated. Timely post-operative endoscopic follow-up with biopsy of suspected lesions is important for early detection of recurrences and associated malignancy.



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