Document Detail

Inverted papilloma of the sphenoid sinus: clinical presentation, management, and systematic review of the literature.
MedLine Citation:
PMID:  19798734     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: Inverted papilloma (IP) of the sphenoid sinus is a rare neoplasm with a nonspecific and insidious presentation that is further complicated by difficult access for assessment and follow-up. In conjunction with a systematic review of the English literature, we review our experience with IP of the sphenoid sinus to better delineate the clinical presentation, prevalence, management, and recurrence of this challenging lesion. METHODS: A systematic search strategy was developed to assess and summarize the best available evidence on sphenoid IP. A retrospective chart review of the 5-year database of one tertiary care Otolaryngology-Head and Neck Surgery practice was performed; all patients with histologically confirmed IP of the nasal cavity or paranasal sinuses were included. RESULTS: Seventy-one patients (49 males, 22 females; mean age, 57.2 years) treated between June 2003 and January 2009 were included. Nine patients were diagnosed with IP originating in the sphenoid sinus. Two of these patients were asymptomatic, and in the remaining seven patients the most common presentation was headache (42.9%), followed by visual disturbances, hearing loss, and nasal obstruction (28.6% each). Review of the literature confirms our finding that the most common presenting symptom is headache (45.0%), followed by nasal obstruction (30.0%) and epistaxis (22.5%). CONCLUSIONS: This is the largest reported series of sphenoid sinus IP in the English literature. We have demonstrated a predominance of neurological and visual symptoms in symptomatic patients with sphenoid IP, and suggest that these may be early manifestations of sphenoid IP, before the more common sinonasal symptoms develop secondary to extension into the nasal cavity and paranasal sinuses.
Jennifer P Guillemaud; Ian J Witterick
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  The Laryngoscope     Volume:  119     ISSN:  1531-4995     ISO Abbreviation:  Laryngoscope     Publication Date:  2009 Dec 
Date Detail:
Created Date:  2009-11-30     Completed Date:  2010-01-05     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8607378     Medline TA:  Laryngoscope     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2466-71     Citation Subset:  IM    
Department of Otolaryngology-Head and Neck Surgery, Mount Sinai Hospital, Toronto, Ontario, Canada.
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MeSH Terms
Aged, 80 and over
Diagnosis, Differential
Endoscopy / methods*
Middle Aged
Otorhinolaryngologic Surgical Procedures / methods*
Papilloma, Inverted / diagnosis,  surgery*
Paranasal Sinus Neoplasms / diagnosis,  surgery*
Retrospective Studies
Review Literature as Topic
Sphenoid Sinus*
Tomography, X-Ray Computed
Treatment Outcome
Young Adult

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