Inverted papilloma. Considerations in 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.
• 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.