# Epidemiological and Surgical Insights into Inverted Papillomas: A Tertiary Center Experience

## TL;DR

This study examines the characteristics and surgical outcomes of inverted papillomas in the nose and sinuses, highlighting their aggressive behavior and risk of turning cancerous.

## Contribution

The paper provides new epidemiological and surgical insights from a single-center experience with inverted papillomas.

## Key findings

- Inverted papillomas predominantly affect males with a male-to-female ratio of 11.5:1.
- Endoscopic resection is effective, but 16% of patients required revision surgery.
- Two cases showed malignant transformation, emphasizing the need for long-term monitoring.

## Abstract

Objective

This study aimed to evaluate the epidemiological characteristics, clinical presentation, diagnostic methods, and surgical outcomes of sinonasal inverted papillomas (IPs) and to compare these findings with those in the existing literature.

Methods

A retrospective review was performed involving 25 patients diagnosed with IPs and treated by a single surgeon at Antalya Education and Research Hospital, a tertiary care center, between January 2015 and December 2021. Data regarding demographics, presenting symptoms, imaging findings, and postoperative outcomes were analyzed.

Results

Of the 25 patients, 23 were male and two were female (male-to-female ratio: 11.5:1). The mean age of the cohort was 54.7 years. The most common symptom was nasal obstruction. The tumor most frequently originated from the medial wall of the maxilla (40%). Pure endoscopic resection was performed in 20 patients, while four (16%) required revision surgery. Malignant transformation occurred in two patients - one with microinvasive squamous cell carcinoma and another with carcinoma in situ.

Conclusions

Although histologically benign, inverted papillomas demonstrate locally aggressive behavior and carry a risk of malignant transformation. Endoscopic surgical techniques offer favorable outcomes with low recurrence rates, but long-term surveillance remains critical.