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149

ICAR SINONASAL TUMORS

TABLE XVI.7 Evidence surrounding the role of treatment of attachment site.

Clinical endpoints

Study

Year LOE Study design Study groups

Conclusion

Spinos et al. 706

Endoscopic endonasal approach to IP with prioritization of pedicle-oriented resection induces durable cure for IP (2/18, 11.1% recurrence), even when multiply recurrent, with low risk for complication (0/18, 0.0%) Endoscopic resection of IP with prioritization of pedicle-oriented resection induces durable cure for IP (0/13, 0.0% recurrence), even when involving the frontal sinus, with low risk for complication (0/13, 0.0%) Insertion-driven resection of IP is adequate for IPs limited to NOE and frontal sinus, whereas centripetal resection should be considered for maxillary IPs IPs originating from maxillary sinus frequently had multifocal attachments but this did not

1. Recurrence 2.

2021

4

Retrospective case series

Patients undergoing EEA for IP with intracranial or intraorbital

Complications

involvement ( n = 18)

Wanget al. 707

2020 4

Retrospective case series

Patients undergoing

1. Recurrence 2.

EEA for IP involving the frontal sinus/recess ( n = 13)

Complications

Ferrari et al. 710

2020 4

Retrospective case series

Patients undergoing

1. Recurrence 2.

EEAfor IP ( n = 210)

Complications

Wuet al. 305

2018 4

Retrospective case series

Patients undergoing EEA for maxillary sinus IP ( n = 28)

1. Recurrence 2.

Complications

impact recurrence when pedicle-oriented resection conducted

Deanet al. 303

Visualization of pedicle in anatomically difficult areas, such as the anterior or anterolateral

1. Recurrence 2.

2015 4

Retrospective case series

Patients undergoing endoscopic modified medial maxillectomy for IP located on the anterolateral maxillary wall ( n = 35) Patients undergoing open, transnasal, or combined approaches with or without adjuvant RT for IP ( n = 57) Patients undergoing either global ESS (sinus demucosalization with bony drilling) or POES for IP ( n = 73)

Complications

maxillary sinus is possible without an open approach

Suhet al. 720

2015 4

Retrospective case series

Recurrence:

1. IP was associated with a 26.8% (18/67 procedures) rate of recurrence 2. Risk factors for recurrence included attachment sites over the optic nerve and carotid artery or evidence of dysplasia or CIS 1. Data confirm efficacy of endonasal endoscopic treatment of IP (0/37, 0.0% recurrence) 2. POES offers an equally effective

seven out of 48 (14.6%)

Complications: NA OS

Pagella et al. 137

1. Recurrence 2.

2014 4

Retrospective case series

Complications

oncologic outcome (1/36, 0.0%) with fewer complications (0/36, 0.0% vs. 6/37, 16.2%, p < 0.05) Abbreviations: EEA, endoscopic endonasal approach; ESS, endoscopic sinus surgery; IP, inverted papilloma; POES, pedicle-oriented endoscopic surgery; RT, radiation therapy.