{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T02:48:42Z","timestamp":1782960522674,"version":"3.54.5"},"reference-count":15,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2025,11,22]],"date-time":"2025-11-22T00:00:00Z","timestamp":1763769600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,11,22]],"date-time":"2025-11-22T00:00:00Z","timestamp":1763769600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Sinonasal inverted papilloma (SNIP) is a benign sinonasal tumor with a tendency to recur and potential for malignant transformation. Dysplasia may be present, ranging from mild to severe. We aim to evaluate the effect of dysplasia on tumor behavior and patient outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Retrospective chart review of SNIP cases from 2002 to 2023 treated by fellowship\u2010trained Rhinologists at seven institutions. Clinical data were extracted, and tumors were histologically confirmed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Four hundred and forty\u2010eight patients were eligible for analysis. The mean age was 58\u2009years with an average postoperative surveillance of 27\u2009months. Most patients had tumors without dysplasia (74.3%), followed by severe (10.5%), mild (10.0%), and moderate (5.1%) dysplasia. The overall recurrence rate was 11.6%. Unifocal attachment was most prevalent in tumors without dysplasia. Among patients with multifocal attachment, recurrence was highest in those with severe dysplasia (38.1%) compared to no dysplasia (17.2%). Unifocal attachment was associated with improved recurrence\u2010free survival in all three histology types (without, mild, and moderate dysplasia).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In the largest study to date examining the effect of dysplasia on patient outcomes, we found that SNIP that has severe dysplasia to be high risk for recurrence while the other three types of dysplasia to be of lower risk. We therefore propose a two\u2010tiered grading system to improve consensus among pathologists and to guide patient counseling. In the treatment of SNIP, high\u2010risk dysplasia is more often associated with multifocal attachment pattern and remains the most challenging to treat.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>3.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/lary.70263","type":"journal-article","created":{"date-parts":[[2025,11,22]],"date-time":"2025-11-22T10:34:26Z","timestamp":1763807666000},"page":"1656-1664","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Sinonasal Inverted Papilloma and Clinical Significance of Dysplasia: A Multi\u2010Institutional Study"],"prefix":"10.1002","volume":"136","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7006-0031","authenticated-orcid":false,"given":"Alexis H.","family":"Kim","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Lenox Hill Hospital, Long Island Jewish Hospital, Northwell Health  New York New York USA"},{"name":"Zucker School of Medicine at Hofstra\/Northwell  Hempstead New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tristan","family":"Tham","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Stanford University  Palo Alto California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-4052-9908","authenticated-orcid":false,"given":"Peter S.","family":"Giannaris","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Lenox Hill Hospital, Long Island Jewish Hospital, Northwell Health  New York New York USA"},{"name":"Zucker School of Medicine at Hofstra\/Northwell  Hempstead New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mostafa","family":"Kokabee","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine Lenox Hill Hospital, Northwell Health  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jadyn","family":"Wilensky","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology\u2010Head and Neck Surgery University of Pennsylvania Health System  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cynthia","family":"Tsang","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery University of California, Irvine  Orange California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beverly Y.","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery University of California, Irvine  Orange California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kush","family":"Panara","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology\u2010Head and Neck Surgery University of Pennsylvania Health System  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3475-0718","authenticated-orcid":false,"given":"Edward C.","family":"Kuan","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery University of California, Irvine  Orange California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Papagiannopoulos","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Rush University Medical Center  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bobby","family":"Tajudeen","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery University of California, Irvine  Orange California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacob G.","family":"Eide","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Henry Ford Health  Detroit Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7377-4782","authenticated-orcid":false,"given":"John R.","family":"Craig","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Henry Ford Health  Detroit Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3113-2685","authenticated-orcid":false,"given":"Rijul S.","family":"Kshirsagar","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Kaiser Permanente  Redwood City California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zachary","family":"Christian","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Baylor College of Medicine  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3838-3890","authenticated-orcid":false,"given":"Tran B.","family":"Locke","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Baylor College of Medicine  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Judd H.","family":"Fastenberg","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Lenox Hill Hospital, Long Island Jewish Hospital, Northwell Health  New York New York USA"},{"name":"Zucker School of Medicine at Hofstra\/Northwell  Hempstead New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark B.","family":"Chaskes","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Lenox Hill Hospital, Long Island Jewish Hospital, Northwell Health  New York New York USA"},{"name":"Zucker School of Medicine at Hofstra\/Northwell  Hempstead New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aron Z.","family":"Pollack","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Lenox Hill Hospital, Long Island Jewish Hospital, Northwell Health  New York New York USA"},{"name":"Zucker School of Medicine at Hofstra\/Northwell  Hempstead New York 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Otorhinolaryngology\u2010Head and Neck Surgery University of Pennsylvania Health System  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3634-2067","authenticated-orcid":false,"given":"Jennifer","family":"Douglas","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology\u2010Head and Neck Surgery University of Pennsylvania Health System  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erle S.","family":"Robertson","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology\u2010Head and Neck Surgery University of Pennsylvania Health System  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jalal","family":"Jalaly","sequence":"additional","affiliation":[{"name":"Department of Pathology University of Pennsylvania Health System  Philadelphia Pennsylvania 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