Multiple Attachment Sites and Broad-Based Attachment Predict Recurrence in Sinonasal Papilloma.

Authors

Hakan Kara, Omer Orak, Ahmet Ozkan, Levent Aydemir, Senol Comoglu, Meryem Nesil Keles Turel

Published in

American journal of rhinology & allergy. Pages 19458924261507128. Nov 13, 2026. Epub Nov 13, 2026.

Abstract

BackgroundAlthough attachment characteristics are associated with sinonasal papilloma recurrence, the independent associations of multiple attachment sites and broad-based attachment remain incompletely defined.ObjectiveThis study evaluated clinical, histological, and surgical predictors of sinonasal papilloma recurrence, emphasizing multiple and broad-based attachment.MethodsA single-center retrospective cohort study was conducted including 178 patients who underwent surgical treatment for sinonasal papilloma between January 2006 and December 2021. Demographic, clinical, and histopathological variables-such as number of surgeries, origin of attachment site, histological subtype, presence of multiple attachment sites, broad-based attachment, follow-up duration, recurrence status, and time to recurrence-were extracted from medical records, operative notes, and surgical videos. Binomial logistic regression was used to identify independent predictors of recurrence.ResultsThe cohort included 178 patients, of whom 167 (93.8%) had inverted papilloma. The mean age was 52.2 ± 7.9 years, and 84.3% of patients were male. The median follow-up duration was 86.9 months (IQR:64.9-100.8). Thirty-one patients (17.4%) were revision cases. Recurrence occurred in 20 patients (11.2%), with a median time to recurrence of 26.4 months (IQR 10.1-45.7). No significant differences were observed between recurrence and nonrecurrence groups regarding age, sex, or histological type (p > 0.05). However, recurrence was significantly associated with the origin of attachment site (frontal sinus), revision cases, multiple attachment sites, and broad-based attachment (p < 0.05). In multivariate analysis, only multiple attachment sites (OR = 18.7, 95% CI:2.6-133.8, p = 0.004) and broad-based attachment (OR = 13.3, 95% CI:2.3-76.9, p = 0.004) remained independently associated with recurrence.ConclusionMultiple attachment sites and broad-based attachment significantly increase recurrence risk-approximately 19- and 13-fold, respectively-highlighting the importance of thorough intraoperative evaluation and complete resection of all tumor attachment sites.

PMID:
43023543
Bibliographic data and abstract were imported from PubMed on 13 Nov 2026.

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