Better surgical outcome by image-guided navigation system in endoscopic removal of sinonasal inverted papilloma

J Craniomaxillofac Surg. 2018 Jun;46(6):937-941. doi: 10.1016/j.jcms.2018.03.012. Epub 2018 Mar 28.

Abstract

Purpose: The purpose of this study was to validate and compare treatment outcomes for endoscopic resection of sinonasal inverted papilloma (IP) with or without the use of a navigation system.

Materials and methods: A total of 58 patients who underwent endoscopic resection of sinonasal inverted papilloma by a single surgeon from 2007 to 2016 at our institution were retrospectively reviewed. Depending on the use of the navigation system, subjects were divided into two groups: a conventional endoscopic resection group without navigation system (CER group) and a navigation-assisted endoscopic resection group (NER group).

Results: There were 24 patients (41.4%) in the CER group and 34 patients (58.6%) in the NER group. Treatment outcomes showed that navigation-assisted endoscopic resection was a more beneficial surgical technique than conventional endoscopic resection for sinonasal IP. Post-surgical recurrence was noted in seven cases (29.2%) in the CER group and two cases (5.9%) in the NER group. Accordingly, the recurrence rate was significantly less in the NER group compared to the CER group (p = 0.026). There were two cases of complications (8.3%) in the CER group comprising cerebrospinal fluid leak and periorbital fat exposure, while no complications were noted for the NER group (p = 0.167).

Conclusion: This study demonstrated that navigation-assisted endoscopic removal of sinonasal IP is helpful for reducing recurrence and avoiding surgical complications. Therefore, navigation systems should be always considered when performing endoscopic removal of sinonasal IP.

Keywords: Endoscopic resection; Inverted papilloma; Navigation system; Recurrence; Treatment outcome.

MeSH terms

  • Adult
  • Aged
  • Endoscopy / instrumentation*
  • Endoscopy / methods*
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Maxillary Sinus / surgery
  • Middle Aged
  • Minimally Invasive Surgical Procedures / methods
  • Papilloma, Inverted / diagnostic imaging*
  • Papilloma, Inverted / surgery
  • Papilloma, Inverted / therapy*
  • Paranasal Sinus Neoplasms / surgery*
  • Paranasal Sinuses / surgery
  • Retrospective Studies
  • Treatment Outcome