Recurrence of sinonasal inverted papilloma following surgical approach: A meta‐analysis

• Published in: The Laryngoscope 2017-01, Vol.127 (1), p.52-58
• Main Authors: Kim, Jong Seung, Kwon, Sam Hyun
• Format: Article
• Language: English
• Subjects: Cohort analysis; Endoscopy; Humans; Inverted papilloma; Laryngoscopy; Meta-analysis; Neoplasm Recurrence, Local; Papilloma, Inverted - pathology; Papilloma, Inverted - surgery; Paranasal Sinus Neoplasms - pathology; Paranasal Sinus Neoplasms - surgery; recurrence; Studies; Tumors
• ISSN: 0023-852X; 1531-4995
• DOI: 10.1002/lary.26222

Objectives/Hypothesis Inverted papilloma (IP) is a rare benign tumor, which is found in the sinonasal area. It is characterized by recurrence, local destruction, and malignant change. Of these, recurrence is a challenging problem to many otolaryngologists. In this study, we evaluated recurrence based on the type of surgical approach using a meta‐analysis. Study Design MEDLINE, Embase, and Cochrane database. Methods Relevant studies were identified by searching the following databases: MEDLINE, Embase, and Cochrane through February 2016. Random‐effects models were used to estimate risk ratio (RR) and 95% confidence interval (CI). The Newcastle‐Ottawa scale was used to assess the quality of cohort studies. Results Our search yielded 14 retrospective cohort studies involving a total of 696 endoscopic approaches and 444 nonendoscopic approaches. The pooled RR for IP recurrence (endoscopic vs. external approach) was 0.56 [95% CI: 0.36‐0.85, I2=48.3%]. A subgroup analysis was also performed. Conclusions Surgical management of IP via an endoscopic approach reduces the risk of recurrence compared to an external approach. Although further data are needed, early‐ stage IP requires endoscopic or endoscopic‐assisted surgery to reduce the risk of tumor recurrence. Level of Evidence NA Laryngoscope, 127:52–58, 2017