Abstract

DE SOUSA FONTES, Aderito et al. Tratamiento combinado del papiloma nasosinusal avanzado, con resección endoscópica y técnicas emergentes de radioterapia. Gac Méd Caracas. [online]. 2017, vol.125, n.4, pp.299-315. ISSN 0367-4762.

Introduction: Sinonasal Papillomas are rare benign tumors with locally aggressive behavior and may be associated with malignancy. Surgical resection is the treatment of choice. In cases without histologic malignancy associated, radiotherapy has been used exceptionally. Objectives: To evaluate clinical outcomes with combination therapy with endoscopic resection and Emerging Radiotherapy Techniques in patients with Sinonasal Papillomas biologically aggressive. Methods: A retrospective study in 15 patients with advanced Sinonasal Papillomas, with extra-sinonasal extension without associated histological malignancy, treated from June 1/2006 to August 1/2016. Sex, age, clinical features, anatomical origin, extrasinonasal involvement, surgical approach, histopathology, Emerging Radiotherapy Techniques protocol used, monitoring and results were evaluated. Results: The average age of patients was 67.5 years. 80 % (n = 13) were males and 20 % (n = 3) were females. 60 % had recurrent tumors and 40 % (n = 6) had primary disease. 93.3 % (n = 14) of treated tumors had inverted papilloma histology (PI) and 6.7 % (n = 1) Oncocytic Papilloma (OP). 53.3 % of patients (n = 8) had disease with orbital extension, 40 % (n = 6) had extension to the skull base and in 6.7 % (n = 1) the involvement included orbital, intracranial and naso-facial soft tissue. All patients were approached endoscopically with resection of the greatest amount of tumor possible. All these patients were treated with post operative Emerging Radiotherapy Techniques. Conclusion: Endoscopic resection associated with Emerging Radiotherapy Techniques is useful in the management of patients with IP and OP with aggressive behavior, without associated malignancy and extrasinonasal extension.

Keywords : Inverted Papilloma; Oncocitic Papilloma; Endoscopic Surgery; Emerging radiotherapy techniques.

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