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Inverted papilloma. Considerations in treatment.

G E Woodson, K T Robbins, L Michaels

    Archives of Otolaryngology (Chicago, Ill. : 1960)
    |December 1, 1985
    PubMed
    Summary
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    Inverted papilloma management varies, but conservative surgery can be effective for localized cases with careful follow-up. Complete excision and malignancy inspection are crucial for successful inverted papilloma treatment.

    Area of Science:

    • Otolaryngology
    • Surgical Oncology

    Background:

    • Inverted papilloma (IP) frequently recurs and can be associated with malignancy, often necessitating aggressive surgical approaches like lateral rhinotomy.
    • While lateral rhinotomy is common, the efficacy of conservative surgical procedures for selected IP cases warrants investigation.

    Observation:

    • A retrospective review of 90 inverted papilloma cases was conducted to evaluate surgical management outcomes.
    • Malignancy was infrequently associated with inverted papilloma in this cohort.
    • Conservative surgery achieved successful disease control in some cases, though often requiring multiple procedures.

    Findings:

    • Complete cure was achieved in a single procedure for all patients with clear sinus films.
    • Aggressive lesions and those with malignancy showed abnormal mitotic activity.

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  • Adequate surgical exposure is essential for complete inverted papilloma excision.

    • Implications:

    • Selected patients with localized inverted papilloma may be managed effectively with conservative surgery, provided diligent follow-up.
    • Thorough inspection of all excised tissue for malignancy is a critical component of inverted papilloma management.
    • The findings support a tailored surgical approach for inverted papilloma based on disease localization and characteristics.