[Inverted nasosinusal papilloma. 11 cases and bibliographic revision]. / Papilomas invertidos nasosinusales. A propósito de 11 casos y revisión de la bibliografía.

INTRODUCTION: We present the cases registred from 1998 to 2003 and a revision of the bibliography. MATERIAL AND METHOD: In the section of Rhinology of a second level Hospital 11 patients affected by inverted papilloma type 1 of the OMS classification were diagnosed aged between 40 and 79, 9 men and 2 women. They were explored through endoscopy and biopsy and the exeresis of the lesion was done by endoscopic polipectomy with microdebrider (PEM). RESULTS: All the cases at stage I, II and III of the Krouse classification. Treated by CEN, 6 by mixed endonasal approach and through the canine fossa 4 by nasal approach only and 1 by Caldwell-Luc approach. The follow-up was done between 9 to 64 months and there was a recidive who was operated by open surgery and no one malignant transformation was seen. DISCUSSION: We coment the aspects related to etiology, the symptons and the surgical technics. CONCLUSIONS: We propose to stage the tumor and the realisation of a PEM with topic anesthesia with deep biopsies in all unilateral poly formations to avoid a retarded diagnosis and to be able to apply endoscopic technics.

Papilomas invertidos nasosinusales. A propósito de 11 casos y revisión de la bibliografía / Inverted nasosinusal papilloma. 11 cases and bibliographic revision

Introducción. Presentamos los casos registrados durante los años 1998 al 2003, haciendo una revisión de la bibliografía. Material y Método. Se diagnosticaron, en la sección de Rinología de un Hospital de 2° nivel, 11 pacientes de Papiloma invertido tipo 1 de la clasificación de OMS, con edades comprendidas entre 40 y 79 años, 9 varones y 2 mujeres. Fueron explorados mediante endoscopia y biopsia, y/o exéresis de la lesión mediante polipectomía endoscópica con microdesbridador (PEM). Resultados. Todos los casos en estadio I, II y III de la clasificación de Krouse. Tratados mediante CEN: 6 con abordaje mixto endonasal y a través de fosa canina, 4 con abordaje sólo endonasal y 1 con abordaje CadlweIl-Luc. Con un seguimiento entre 9 y 64 meses, hubo una recidiva que fue intervenida por cirugía abierta, y ninguna transformación maligna. Discusión. Comentamos los aspectos relacionados con la etiología, los síntomas y las técnicas quirúrgicas. Conclusiones. Proponemos el estadiaje del tumor y la realización de una PEM con anestesia tópica con biopsias profundas en todas las formaciones poliposas unilaterales para evitar el diagnóstico tardío y poder aplicar técnicas endoscópicas

Introduction: We present the cases registred from 1998 to 2003 and a revision of the bibliography. Material and Method: In the section of Rhinology of a second level Hospital 11 patients affected by inverted papilloma type 1 of the OMS classification were diagnosed aged between 40 and 79, 9 men and 2 women. They were explored through endoscopy and biopsy and the exeresis of the lesion was done by endoscopic polipectomy with microdebrider (PEM). Results: All the cases at stage I, II and III of the Krouse classification. Treated by CEN, 6 by mixed endonasal approach and through the canine fossa 4 by nasal approach only and 1 by Caldwell-Luc approach. The follow-up was done between 9 to 64 months and there was a recidive who was operated by open surgery and no one malignant transformation was seen. Discussion: We coment the aspects related to etiology, the symptons and the surgical technics. Conclusions: We propose to stage the tumor and the realisation of a PEM with topic anesthesia with deep biopsies in all unilateral poly formations to avoid a retarded diagnosis and to be able to apply endoscopic technics