Inverting papilloma of the nose: analysis of 48 patients

Forty-eight cases of inverting papilloma of the nose and paranasal sinuses treated by a number of surgeons at the University of Toronto from the years 1976 to 1985 are presented. Age at diagnosis, duration of symptoms, male predominance, associated symptoms and location of tumor were found to be similar to previous studies. A 4% incidence of an associated nasal carcinoma was found while 2% progressed to papillary squamous carcinoma. A minimum five-year follow-up was obtained in 18 cases, demonstrating an overall recurrence rate of 39%. Polypectomy resulted in a 75% recurrence, compared to a 27% recurrence rate following lateral rhinotomy and medial maxillectomy. The average disease-free period was 4.1 years. Lateral rhinotomy and medial maxillectomy is suggested as the minimum procedure to control inverting papillomas of the lateral nasal wall. Lesions confined to the septum can be best managed by wide local excision. An extended period of follow-up is recommended in all of these patients.