Inverted papilloma of the sphenoid sinus: Clinical presentation, management, and systematic review of the literature
Bibliographic record
Abstract
OBJECTIVES: Inverted papilloma (IP) of the sphenoid sinus is a rare neoplasm with a nonspecific and insidious presentation that is further complicated by difficult access for assessment and follow-up. In conjunction with a systematic review of the English literature, we review our experience with IP of the sphenoid sinus to better delineate the clinical presentation, prevalence, management, and recurrence of this challenging lesion. METHODS: A systematic search strategy was developed to assess and summarize the best available evidence on sphenoid IP. A retrospective chart review of the 5-year database of one tertiary care Otolaryngology-Head and Neck Surgery practice was performed; all patients with histologically confirmed IP of the nasal cavity or paranasal sinuses were included. RESULTS: Seventy-one patients (49 males, 22 females; mean age, 57.2 years) treated between June 2003 and January 2009 were included. Nine patients were diagnosed with IP originating in the sphenoid sinus. Two of these patients were asymptomatic, and in the remaining seven patients the most common presentation was headache (42.9%), followed by visual disturbances, hearing loss, and nasal obstruction (28.6% each). Review of the literature confirms our finding that the most common presenting symptom is headache (45.0%), followed by nasal obstruction (30.0%) and epistaxis (22.5%). CONCLUSIONS: This is the largest reported series of sphenoid sinus IP in the English literature. We have demonstrated a predominance of neurological and visual symptoms in symptomatic patients with sphenoid IP, and suggest that these may be early manifestations of sphenoid IP, before the more common sinonasal symptoms develop secondary to extension into the nasal cavity and paranasal sinuses.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.003 | 0.001 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".