The endoscopic approach worked well not only to remove large inverted papillomas in 18 patients ages 36 to 74 but also to watch for regrowth of the tumours that have a high recurrence rate and a small chance of becoming cancer. Patients were treated as outpatients and 56 percent remained disease-free at 29 months.
“If there is a chance to cure benign disease using minimally invasive techniques, it always works best for the patient,” says Dr. Stil E. Kountakis, vice chair of the Medical College of Georgia Department of Otolaryngology-Head and Neck Surgery and director of the Georgia Sinus and Allergy Center. “Endoscopic techniques allow you to support the ancient dictum of do no harm and, at the same time, provide care to the patient.”
“Without treatment, it can grow big,” says Kounakis, corresponding author on the study. “Tumours may come from the wall of the sinuses behind the cheekbone that is next to the nose. They can spread out into the sinuses between the eyes. They can go over the surface of the eye socket, go up to the skull base. It’s a slow-growing tumour but it’s a destructive tumour.”
Previous studies have looked at removing less-extensive tumours endoscopically but rhinologists, such as Dr. Kountakis, are pushing the envelope, looking at its potential in advanced disease.
“Operative risk and post-operative morbidity are significantly less than with open procedures,” study authors write. “Recurrences are more frequent, but are detected early and are easily resected with minimally invasive techniques.” Study patients had about a 50 percent recurrence rate compared to the usual recurrence rate of up to 44 percent.
MEDICA.de; Source: Medical College of Georgia