Inverted papilloma of the nose and paranasal sinuses

Abstract

Inverted papilloma of the nose and paranasal sinuses is an uncommon lesion recognized as a neoplastic growth of the epithelium which inverts into the underlying stroma rather than proliferating outwardly from the surface. This neoplasm is uniquely characterized by its capacity to destroy bone, tendency to recur after incomplete removal, and association with malignancy. Most authors recommend lateral rhinotomy as the initial surgical approach. In 1992 and 1993, we treated 5 patients with inverted papilloma, one of which presented with bilateral disease. On computed tomography, 3 patients demonstrated opacification of the maxillary sinus, 2 showed localized mass. None of the patients showed bone destruction. Antrostomy and ethmoidectomy were performed in 5 of these cases. Lateral rhinotomy was added in one patient. Intranasal ethmoidectomy was performed in one case. Complete resection and lifelong follow-up are recommended to prevent recurrence and association with malignancy.