Background:
Inverted papilloma (IP) is an epithelial mucosal tumor of the nasal and paranasal
sinuses (NPS), which recurs in up to 70% of cases after surgical treatment and degenerates
in up to 15% malignant. Thus, there is a need to improve preoperative diagnosis, clinical
follow-up and in case of recurrence for surgical revision.
Objective:
Systematic literature review to assess sensitivity and specificity of diagnostic imaging
of IP as well as the IP's origin with regard to targeted surgical therapy.
Methods:
Systematic analysis of PubMed-listed original papers published between January 2000
and September 2018 with the following inclusion criteria: CT, PET-CT and MRI diagnostics
of IP in the NPS in English or German language.
Results:
19 publications could be identified. CT diagnosis is sensitive to pathological changes
in the paranasal sinuses (54.6% – 98.33%), but with low specificity (0% – 69.2%) for
IP. Radiological signs such as hyperostosis or osteitis often correlated with the
origin of the IP but did not represent a particularly sensitive marker.
Conclusion:
The benefit of CT diagnostics in diagnosing an IP is still limited. The low specificity
does not allow the delineation of the IP against changes that also occur in other
diseases such as chronic rhinosinusitis. The combination of CT and MRI can simplify
treatment planning, but is rarely feasible in everyday clinical practice for economic
reasons.
