Surgical management of frontal sinus inverted papilloma: A systematic review

Evan Walgama, Chul Ahn, Pete S. Batra

Research output: Contribution to journalArticle

35 Citations (Scopus)

Abstract

Objectives/Hypothesis: Surgical management of frontal sinus (FS) inverted papilloma (IP) remains a significant challenge. This study systematically reviews the FS IP literature to delineate outcomes based on surgical strategy. Study Design: Systematic review. Methods: Cases for inclusion were identified by literature query for the terms frontal sinus and inverted papilloma between 1995 and 2010. Cases reported with sufficient outcomes data, defined as specific surgical approach and disease-free follow-up, were included. Statistical analysis was performed to identify significant risk factors for recurrence. The reported length of follow-up for each surgical approach was analyzed as an indicator of the strength of the reported literature for each approach. Results: Fifty-seven cases were identified in 13 studies, with 49 cases deemed adequate for additional analysis. Twenty-four cases (49%) were primary, and 25 (51%) were secondary (residual or recurrent disease) IP. Bilateral FS involvement was reported in eight cases (16.3%). Surgical approaches employed included endoscopic frontal sinusotomy (EFS) in 21 (42.9%), endoscopic modified Lothrop (EML) in 10 (20.4%), osteoplastic flap in 13 (26.5%), and endoscopic trephination and EFS in five (10.2%) patients. The overall rate of recurrence was 22.4%. Mean follow-up time was 27 months. Conclusions: The recent reported literature of FS IP demonstrates high prevalence of recurrent and bilateral cases. Although statistical analysis of this accrued data is unable to delineate the best surgical approach for FS IP, more aggressive approaches frequently employed for secondary or bilateral disease may facilitate better disease control.

Original languageEnglish (US)
Pages (from-to)1205-1209
Number of pages5
JournalLaryngoscope
Volume122
Issue number6
DOIs
StatePublished - Jun 2012

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Inverted Papilloma
Frontal Sinus
Trephining
Recurrence
Statistical Data Interpretation

Keywords

  • endoscopic frontal trephination
  • endoscopic modified Lothrop
  • endoscopic tumor resection
  • frontal sinus
  • Inverted papilloma
  • osteoplastic flap
  • sinonasal papilloma

ASJC Scopus subject areas

  • Otorhinolaryngology

Cite this

Surgical management of frontal sinus inverted papilloma : A systematic review. / Walgama, Evan; Ahn, Chul; Batra, Pete S.

In: Laryngoscope, Vol. 122, No. 6, 06.2012, p. 1205-1209.

Research output: Contribution to journalArticle

Walgama, Evan ; Ahn, Chul ; Batra, Pete S. / Surgical management of frontal sinus inverted papilloma : A systematic review. In: Laryngoscope. 2012 ; Vol. 122, No. 6. pp. 1205-1209.
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abstract = "Objectives/Hypothesis: Surgical management of frontal sinus (FS) inverted papilloma (IP) remains a significant challenge. This study systematically reviews the FS IP literature to delineate outcomes based on surgical strategy. Study Design: Systematic review. Methods: Cases for inclusion were identified by literature query for the terms frontal sinus and inverted papilloma between 1995 and 2010. Cases reported with sufficient outcomes data, defined as specific surgical approach and disease-free follow-up, were included. Statistical analysis was performed to identify significant risk factors for recurrence. The reported length of follow-up for each surgical approach was analyzed as an indicator of the strength of the reported literature for each approach. Results: Fifty-seven cases were identified in 13 studies, with 49 cases deemed adequate for additional analysis. Twenty-four cases (49{\%}) were primary, and 25 (51{\%}) were secondary (residual or recurrent disease) IP. Bilateral FS involvement was reported in eight cases (16.3{\%}). Surgical approaches employed included endoscopic frontal sinusotomy (EFS) in 21 (42.9{\%}), endoscopic modified Lothrop (EML) in 10 (20.4{\%}), osteoplastic flap in 13 (26.5{\%}), and endoscopic trephination and EFS in five (10.2{\%}) patients. The overall rate of recurrence was 22.4{\%}. Mean follow-up time was 27 months. Conclusions: The recent reported literature of FS IP demonstrates high prevalence of recurrent and bilateral cases. Although statistical analysis of this accrued data is unable to delineate the best surgical approach for FS IP, more aggressive approaches frequently employed for secondary or bilateral disease may facilitate better disease control.",
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