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Inverted Sinonasal Papilloma: Possibility of Prediction of the Tumor Insertion

Publication at Third Faculty of Medicine |


Introduction: Sinonasal inverted papilloma is a benign and relatively rare tumor of the sinonasal tract. The tumor is characterized by destructive growth, frequent recurrences and coincident with squamous cell carcinoma.

Currently, the endoscopic surgery is considered to be basic treatment modality for inverted papillomas. The identification of the tumor insertion represents the most important step of the surgical procedure.

The insertion can be predicted preoperatively using imaging methods, especially by searching for so-called focal hyperostosis. The aim of the study is prospective evaluation possible correlation between pre and perioperative identification of the tumor insertion.

Material and methods: In 27 patients with histologically confirmed inverted papilloma, the insertion was preoperatively determined by identification of focal hyperostosis. The expected location was then correlated with perioperative finding.

Results: The preoperative analysis of CT scans revealed hyperostosis in 74 % of patients. The pre- and perioperative correlation of the tumor insertion was 95 %.

Conclusion: Once the focal hyperostosis is identified, the location likely corresponds with the tumor insertion. The preoperative identification of the tumor insertion enables planning of the extent of the procedure with good radicality and minimal morbidity.