Endoscopic Management of Inverted Papilloma Using CT Scan as the Predictor of Tumour Origin
Introduction Inverted papillomas are notorious for recurrence. The surgical cause attributed to recurrence is failure to achieve good surgical exposure and inadequate clearance of disease. Pre-operative prediction about the site of origin by CT Scan may contribute to a better surgical outcome. This...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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The Association of Otolaryngologists of India, West Bengal
2017-08-01
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| Series: | Bengal Journal of Otolaryngology and Head Neck Surgery |
| Subjects: | |
| Online Access: | http://bjohns.in/journal/index.php/bjohns/article/view/236 |
| _version_ | 1797283997179445248 |
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| author | Ravi Roy Vijay Bhalla Ankit Mathur N Ramakrishnan |
| author_facet | Ravi Roy Vijay Bhalla Ankit Mathur N Ramakrishnan |
| author_sort | Ravi Roy |
| collection | DOAJ |
| description | Introduction
Inverted papillomas are notorious for recurrence. The surgical cause attributed to recurrence is failure to achieve good surgical exposure and inadequate clearance of disease. Pre-operative prediction about the site of origin by CT Scan may contribute to a better surgical outcome. This study was undertaken to assess if focal hyperostosis on pre-operative CT scan can be considered to be a predictor of the site of tumour origin and correlate with endoscopic finding of the site of origin.
Materials and Method
A prospective descriptive study was carried out between Jan 2014 and May 2016. Fifteen patients of histopathologically proven inverted papilloma that reported during this time period were evaluated using contrast enhanced CT Scan and subsequently underwent endoscopic excision of tumour identifying the tumour origin. Assessment of age, gender, symptoms, pre-operative staging, location of the tumour origin on CT Scan and surgical correlation of origin was done. Post-operative follow-up was done at 1 month, 3 months and 6 monthly thereafter.
Results
Six (40%) were classified as Krouse II and nine (60%) were classified as Krouse III. 12 (80%) arising from maxillary sinus, 02 (13.3%) arising from maxillary sinus and anterior ethmoids and 01 (6.7%) from sphenoid. Thirteen (86.7%) cases CT scan could predict the tumour origin which was confirmed during surgery. All cases managed by endoscopic technique with no recurrence or co-existence of malignancy.
Discussion
Focal hyperostosis in the walls of paranasal sinus is seen to be associated with IP tumour origin, the cause of which is not fully understood. It is hypothesized that tumour induced inflammation at the site of origin leads to bone remodeling and increased bone deposition with vascularity at the site of attachment.
Conclusion
CT scan is a good predictor of tumour origin and a conservative endoscopic approach can be planned accordingly for complete clearance of disease. |
| first_indexed | 2024-03-07T17:42:39Z |
| format | Article |
| id | doaj.art-204ae37689b246ca8a67901a57f9942a |
| institution | Directory Open Access Journal |
| issn | 2395-2393 2395-2407 |
| language | English |
| last_indexed | 2024-03-07T17:42:39Z |
| publishDate | 2017-08-01 |
| publisher | The Association of Otolaryngologists of India, West Bengal |
| record_format | Article |
| series | Bengal Journal of Otolaryngology and Head Neck Surgery |
| spelling | doaj.art-204ae37689b246ca8a67901a57f9942a2024-03-02T15:53:20ZengThe Association of Otolaryngologists of India, West BengalBengal Journal of Otolaryngology and Head Neck Surgery2395-23932395-24072017-08-012526368115Endoscopic Management of Inverted Papilloma Using CT Scan as the Predictor of Tumour OriginRavi Roy0Vijay Bhalla1Ankit Mathur2N Ramakrishnan3Command Hospital (Eastern Command), Kolkata. West Bengal University of Health ScienceDept of ENT, Command Hospital (Eastern Command), Alipore Road, Kolkata- 700 027, West BengalDept of Radiology, Command Hospital (Eastern Command), Alipore Road, Kolkata- 700 027Dept of ENT, Command Hospital (Eastern Command), Alipore Road, Kolkata- 700 027 West BengalIntroduction Inverted papillomas are notorious for recurrence. The surgical cause attributed to recurrence is failure to achieve good surgical exposure and inadequate clearance of disease. Pre-operative prediction about the site of origin by CT Scan may contribute to a better surgical outcome. This study was undertaken to assess if focal hyperostosis on pre-operative CT scan can be considered to be a predictor of the site of tumour origin and correlate with endoscopic finding of the site of origin. Materials and Method A prospective descriptive study was carried out between Jan 2014 and May 2016. Fifteen patients of histopathologically proven inverted papilloma that reported during this time period were evaluated using contrast enhanced CT Scan and subsequently underwent endoscopic excision of tumour identifying the tumour origin. Assessment of age, gender, symptoms, pre-operative staging, location of the tumour origin on CT Scan and surgical correlation of origin was done. Post-operative follow-up was done at 1 month, 3 months and 6 monthly thereafter. Results Six (40%) were classified as Krouse II and nine (60%) were classified as Krouse III. 12 (80%) arising from maxillary sinus, 02 (13.3%) arising from maxillary sinus and anterior ethmoids and 01 (6.7%) from sphenoid. Thirteen (86.7%) cases CT scan could predict the tumour origin which was confirmed during surgery. All cases managed by endoscopic technique with no recurrence or co-existence of malignancy. Discussion Focal hyperostosis in the walls of paranasal sinus is seen to be associated with IP tumour origin, the cause of which is not fully understood. It is hypothesized that tumour induced inflammation at the site of origin leads to bone remodeling and increased bone deposition with vascularity at the site of attachment. Conclusion CT scan is a good predictor of tumour origin and a conservative endoscopic approach can be planned accordingly for complete clearance of disease.http://bjohns.in/journal/index.php/bjohns/article/view/236Papilloma, InvertedTomography, X-Ray ComputedHyperostosis |
| spellingShingle | Ravi Roy Vijay Bhalla Ankit Mathur N Ramakrishnan Endoscopic Management of Inverted Papilloma Using CT Scan as the Predictor of Tumour Origin Bengal Journal of Otolaryngology and Head Neck Surgery Papilloma, Inverted Tomography, X-Ray Computed Hyperostosis |
| title | Endoscopic Management of Inverted Papilloma Using CT Scan as the Predictor of Tumour Origin |
| title_full | Endoscopic Management of Inverted Papilloma Using CT Scan as the Predictor of Tumour Origin |
| title_fullStr | Endoscopic Management of Inverted Papilloma Using CT Scan as the Predictor of Tumour Origin |
| title_full_unstemmed | Endoscopic Management of Inverted Papilloma Using CT Scan as the Predictor of Tumour Origin |
| title_short | Endoscopic Management of Inverted Papilloma Using CT Scan as the Predictor of Tumour Origin |
| title_sort | endoscopic management of inverted papilloma using ct scan as the predictor of tumour origin |
| topic | Papilloma, Inverted Tomography, X-Ray Computed Hyperostosis |
| url | http://bjohns.in/journal/index.php/bjohns/article/view/236 |
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