Different options for treatment of inverting papilloma of the nose and paranasal sinuses: A report of 41 cases

Abstract

Forty-two cases of inverting papilloma of the nose and paranasal sinuses were reviewed from 1972 to 1989. Forty-one patients underwent surgical excision. Of those patients followed up for at least 6 months, lateral rhinotomy was performed in 14 patients and midfacial degloving in 9 patients. The recurrence rates were 29% and 22%, respectively. The other 10 patients underwent excision through an external ethmoidectomy, Caldwell-Luc operation, or intranasal approach. There were five patients (12%) diagnosed with squamous cell carcinoma associated with inverting papilloma. The correlation of malignancy with proptosis, visual changes, infraorbital hypesthesia, and skull base involvement on presenting symptomatology is noted. Inverting papilloma is a benign neoplastic lesion that shows variable aggressiveness. A computed tomography (CT) scan evaluation is very important for the work-up. An aggressive wide surgical excision is best performed through an open approach. The approach for surgical removal should be based on the location and extension of the lesion. A graduating approach from a lesser to a more major excision is advocated even though a risk exists of having to reoperate in about one fifth of the patients who experience a recurrence. A secondary surgical excision, even with craniofacial resection, is essential to eradicate disease in cases of recurrence. Close follow-up is necessary. Further surgery may be indicated. Post-operative radiation therapy is recommended if malignancy is indeed present.

Schneiderian Papillomas and Nonsalivary Glandular Neoplasms of the Head and Neck

“…Inverted papillomas (IP) are two to five times more common in males and are found primarily in the 40 -70-year age group (2,3,8,14,15,(23)(24)(25)(26)(27)(28)(29)(30). The 6-year-old boy included in the series of Eavey (31) is one of the youngest patients yet described with this papilloma.…”

A Study On The Clinical Profile And Management Of Inverted Papilloma

“…[4] The presenting symptoms seen in this study were similar with the findings of many authors who believe that the signs and symptoms of the disease depend on the location and extent of the tumour. [3,4,6,8,10] The reported duration of symptoms in our series was 1 day to 30 years. A 10-year-old girl presented with epistaxis for only 1 day.…”

Treatment Of Bilateral Squamous Cell Carcinoma Of The Paranasal Sinuses Using Bilateral Lateral Rhinotomies

“…İnverted papillom %5-13 oranında malign transformasyon göstermektedir [3][4][5][6][7][8][9] . İP zemininde senkron olarak gelişmiş bilateral YHK literatürde bildirilmemiştir.…”

“…BT, inverted papillomlu olguların tanı ve takibinde özellikle endoskopik muayene ile değerlendirmenin zor olduğu sfenoid, maksiller sinüs lateral duvarı ve fontal sinüsün değerlendirilmesinde endoskopiye göre daha iyi bilgi vermektedir [10]. Bizim vakamızda bilateral arka etmoid hücre-ler kısmen, ön etmoid hücreler ve bilateral maksiller sinüsler tamamen kitle ile oblitereydi.…”

“…Epitelin dışarı doğru değil de, içe doğru dönüp stromaya doğru çoğalmasıyla karakterizedir 2 . Tüm sinonazal tümörlerin % 0,5 -4'ünü oluşturmaktadır [2][3][4][5][6][7] . İP sıklıkla nazal kavite lateral duvarından kaynaklanır ve maksiller, etmoid, frontal ve sfenoid sinüslere yayılım gösterebilmek-tedir.…”