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Sinonasal tumours
Published in Neeraj Sethi, R. James A. England, Neil de Zoysa, Head, Neck and Thyroid Surgery, 2020
Yujay Ramakrishnan, Shahzada Ahmed
Long-term follow-up is recommended to detect recurrence or transformation, as the disease can become quite extensive before it becomes symptomatic. In challenging inverted papilloma cases with multiple recurrences, 5-fluorouracil may have a place postoperatively [22]. The rates of synchronous and metachronous carcinomatous transformation of inverted papilloma are 7.1% and 3.6%, respectively. The mean time taken to develop a metachronous carcinoma in a systematic review was reported to be 52 months (range 6 to 180 months) [23].
Diseases
Published in William Bonnez, Guide to Genital HPV Diseases and Prevention, 2019
The clinical manifestations of the mucosogenital HPV infections are the direct consequence of the epithelial proliferation induced by the virus. This proliferation, which is dependent on poorly understood factors, some of which are related to the anatomic location, can protrude to a variable extent above the plane of the normal skin or mucosa, causing papules ranging in height from flat to exuberant. The proliferation also extends below the plane of the epidermis. When limited exclusively to below the tissue surface and benign, it creates an inverted papilloma. Cancers related to HPV can range from fungating to infiltrative, and from small to very large. Therefore, the diagnosis of HPV diseases relies primarily on inspection—sometimes aided by optical magnification and tissue biological stains, and palpation. When lesions are poorly accessible or visible, when malignancy is a concern, or simply when the clinical diagnosis is uncertain, a biopsy is usually the definitive diagnostic tool. For the screening of uterine or anal cancers and the detection of their precursor lesions, the cytology of cells exfoliated from these sites may precede any direct examination and biopsy.
The Frontal Sinus
Published in John C Watkinson, Raymond W Clarke, Louise Jayne Clark, Adam J Donne, R James A England, Hisham M Mehanna, Gerald William McGarry, Sean Carrie, Basic Sciences Endocrine Surgery Rhinology, 2018
Inverted papilloma (IP) are relatively uncommon benign epithelial tumours of the nasal cavity. They are locally aggressive, have a tendency to recur and are associated with malignancy. Histologically, the tumour is characterized by epithelium inverting into the stroma with a distinct and intact basement membrane. Human papilloma virus has been implicated in the pathogenesis. Viral DNA has been found in the adjacent normal appearing tissue and may account for the associated recurrence rates although in many cases this is due to residual disease. The incidence of IP in normal bilateral nasal polyps is rare (<1%). As multiple sites within the paranasal sinus may be involved, localization of the origin is not always easy. The commonest sites of origin are the ethmoid region (48%), lateral nasal wall and maxillary sinus (28%) with the frontal sinus accounting for only 2.5%.98 Bilateral frontal sinus involvement is not uncommon (16%).99
Is tooth conservation possible in odontogenic sinusitis? Prospective evaluation of affected teeth condition-based protocol
Published in Acta Oto-Laryngologica, 2023
Akiko Ito, Muneo Nakaya, Kazuhiro Tada, Junko Kumada, Wataru Kida, Yasuhiro Inayoshi
ESS was performed under general anesthesia. Uncinectomy, middle meatal antrostomy, anterior and posterior ethmoidectomy, and frontal sinusotomy were performed in all the patients. In some cases, a sphenoidotomy was added depending on the extent of the disease. A septoplasty was performed in patients with septal deviation toward the affected side. Counter opening in the inferior meatus was performed to remove the maxillary sinus mucosa with granulation tissue. At the end of the surgery, the sinus was rinsed with saline. If a periapical abscess or radicular cyst was identified at the bottom of the maxillary sinus using a 70° endoscope, the granulation tissue and cyst were removed to decrease pathogens (Figure 3). All the participants gave their written informed consent for the implementation of the present treatment protocol and of any, required, additional procedures for the treatment of periapical lesions or radicular cysts during ESS. Patients whose intraoperative findings revealed an inverted papilloma or eosinophilic sinusitis were excluded.
Recurrent respiratory epithelial adenomatoid hamartoma of the nasal cavity
Published in Baylor University Medical Center Proceedings, 2022
Dhananjay Kumar, K. K. Handa, Aru Handa, Poonam Gautam
A hamartoma is a benign malformation or congenital error of tissue development and is indigenous to a specific part of the body. The term was first used by Albrecht in 1904. It is common in the lung, kidney, liver, spleen, and intestine but rare in the head and neck region, particularly the nasal cavity and paranasal sinuses. Respiratory epithelial adenomatoid hamartoma (REAH) is the most common hamartoma of the sinonasal tract, first recognized by Wenig and Heffner in 1995. It is defined as a tumor originating from the surface epithelium with excessive proliferation of glandular elements but not originating from the seromucinous gland. The usual age of occurrence is the third to ninth decade, and the male-to-female ratio is 3:2. Most REAHs are unilateral and occur in the posterior nasal septum; less commonly they arise in the middle meatus, lateral nasal wall, ethmoid sinus, maxillary sinus, inferior turbinate, and nasopharynx.1 The clinical presentation includes nasal obstruction, congestion, epistaxis, rhinorrhea, chronic sinusitis, facial pain, headache, and olfactory dysfunction. REAH can be misdiagnosed as inverted papilloma or well-differentiated adenocarcinoma clinically as well as histopathologically. Thus, it is important to make the correct diagnosis, as complete excision through a conservative approach is the treatment of choice for REAH.2
ErbB1 and ErbB2 overexpression in patients with sinonasal inverted papilloma and inverted papilloma with squamous cell carcinoma in China
Published in Acta Oto-Laryngologica, 2019
Hongbing Li, Li Hu, Huankang Zhang, Dehui Wang
Surgical resection specimens from hospitalized patients with complete medical data were collected in the Department Otorhinolaryngology and Head and Neck Surgery at the Eye and ENT Hospital of Fudan University, between 2017 and 2018. The SNIP tissue specimens used in the histological studies were obtained from 16 SNIP patients, and the SNIP tissue specimens used for RNA extraction were obtained from an additional 16 SNIP patients. According to the WHO classification of squamous epithelial dysplasia [9], SNIP epithelial dysplasia was classified into 4 grades: grade 0, no dysplasia; grade 1, mild dysplasia; grade 2, moderate dysplasia; and grade 3, severe dysplasia. The pathological diagnosis of the SNIP specimens, including the dysplasia grade, was confirmed by the same pathologist. As control samples, eight NNM biopsy specimens were collected from normal uncinate process mucosal tissues resected during optic nerve decompression, cerebrospinal fluid rhinorrhoea repair, or benign sinonasal tumor surgery. Each NNM tissue specimen was divided into two parts. One part was used for RNA extraction, and the other was used for histological detection. In addition, nine paraffin sections of IPwSCC tissues were retrieved from the Department of Pathology of our hospital for histological detection. None of the NNM, SNIP, and IPwSCC patients received any treatment before surgery. Clinical staging of SNIP and IPwSCC adopted the staging system for inverted papilloma proposed by Krouse [10] in 2000. Demographic and clinicopathological data for all subjects in this study are listed in Table 1.