Nasal Schneiderian papillomas: a study of 83 cases

Nasal Schneiderian papillomas are unique lesions involving the mucosa of the nasal cavity and paranasal sinuses. Most often epidermoid in histological appearance, they favour 2 sites: the septum and the lateral wall of the nasal cavity. The medical literature on these tumours contains a plethora of contradictions concerning the nomenclature and no less than 54 separate designations are used. The synonyms are discussed and the term Schneiderian papilloma is proposed as the most suitable alternative. This study includes 83 patients with Schneiderian papillomas in whom the history, clinical and radiological findings, treatment procedures, pathological sections, recurrences, and associated malignancies were analyzed. Histological and clinical features were not helpful in predicting recurrence, but the recurrence rate was related to the treatment modalities; with 17% recurrences using an extranasal approach (lateral rhinotomy) and 59% using intranasal approach with limited excision. Schneiderian papillomas were associated with squamous cell carcinoma in 7 patients. Simultaneous papilloma and carcinoma were demonstrated in 4 patients at presentation (5%) and subsequently developing carcinoma in 3 patients (4%). As recurrences are frequent after inadequate removal and as association with maligancies may occur in both septal and lateral wall papillomas, radical aggressive surgery, thorough histological examination of the entire specimen, and careful follow-up are advocated.