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Objectives: To assess malignant transformation rate, non‐sinonasal malignancies, and factors contributing to recurrence in patients treated for sinonasal inverted papilloma (SNIP). Study Design: Retrospective study. Methods: We retrospectively reviewed medical records of all patients treated for SNIP (n = 296) between the years 1984–2014 at Helsinki University Hospital. Data from the Finnish Cancer Registry confirmed the number of those patients with sinonasal and non‐sinonasal malignancies. Results: Only 2 of 296 (0.7%) patients primarily diagnosed with benign SNIP developed sinonasal cancer in a mean follow‐up of 5.8 years. The most common non‐sinonasal cancer sites were similar to those reported for the whole Finnish population. None of the patients presented with an HPV‐associated non‐sinonasal malignancy. The recurrence rate among patients who underwent attachment‐oriented surgery was significantly lower compared to those operated on with other approaches (40.2% vs. 56.6%, p = 0.006). Dysplasia in SNIP was associated with a higher recurrence rate (p < 0.001). Conclusions: Malignant transformation of SNIP was rare. Patients with SNIP were not prone to HPV‐associated non‐sinonasal malignancies. Endoscopic resection and attachment‐oriented surgery have become predominant approaches in the treatment of SNIP; meanwhile, the total number of SNIP recurrences has decreased. Level of Evidence: 3 Laryngoscope, 133:506–511, 2023 [ABSTRACT FROM AUTHOR]

Objectives: The present study aimed to evaluate human papillomavirus (HPV) occurrence in sinonasal inverted papilloma (SNIP), and to assess factors associated with HPV positivity and SNIP recurrence. Study Design: Prospective study. Methods: We prospectively collected clinical data and fresh tissue specimens from 90 consecutive patients treated for SNIP at Helsinki University Hospital, between 2015 and 2019. Fourteen patients with recurrent SNIP underwent repeated tumor sampling. All tissue specimens were analyzed for the presence of HPV. Factors associated with SNIP recurrence and HPV positivity were assessed. Results: Among 107 SNIP specimens, 14 (13.1%) were positive for low‐risk HPV and 6 (5.6%) were positive for high‐risk HPV. HPV positivity was associated with an increased risk of recurrence (P =.004). Smoking was significantly associated with HPV positivity in SNIP (P =.01), but a history of HPV‐related diseases or patient sexual habits did not correlate with HPV positivity. The recurrence rate was lower among patients with SNIP that underwent an attachment‐oriented resection, compared to patients treated without attachment‐oriented resections (78.6% vs 25.8%, P <.001). Conclusions: The risk of SNIP recurrence was highly associated with 1) HPV positivity and 2) surgery without an attachment‐oriented resection. Oncogenic HPV was rare in SNIP. Level of Evidence: 3 Laryngoscope, 132:1714–1718, 2022 [ABSTRACT FROM AUTHOR]

Objective: To study whether balloon Eustachian tuboplasty (BET) is a feasible and safe procedure under local anesthesia.Study Design: Prospective multicenter case-control study.Methods: Patients undergoing either BET (n = 13) or endoscopic sinus surgery (ESS) (n = 12) under local anesthesia, with the possibility of sedation and analgesia, were monitored during the procedure and recovery period for possible adverse effects. After the procedure, the patients responded to a questionnaire assessing their experience.Results: No adverse effects were detected in the BET group. Patients in the BET group reported similar Visual Analog Scale scores for pain during the operation as the ESS group (5.0 ± 0.7 vs. 3.2 ± 0.7, mean ± standard error of the mean). However, patients in the BET group experienced more discomfort (4.2 ± 0.6 vs. 2.5 ± 0.3, respectively, P = 0.049). Seventy-seven and 92% of the patients in the BET and ESS groups, respectively, considered the anesthesia and pain relief to be sufficient. Patients from both the BET and ESS groups were almost devoid of pain 1 to 2 hours postoperatively (0.8 ± 0.2 and 1.4 ± 0.3, respectively). In total, 12 of 13 patients in the BET group, and all 12 patients in the ESS group, would choose local anesthesia with sedation and analgesia if they needed to undergo the same procedure again.Conclusion: BET is a safe and feasible procedure under monitored anesthesia care, including local anesthesia along with sedation and analgesia. There is need for further methodological improvement to reduce pain and discomfort during the operation.Level Of Evidence: 4. Laryngoscope, 127:1021-1025, 2017. [ABSTRACT FROM AUTHOR]