Inverted papilloma is a type of neoplasm of epithelial origin that develops on the mucosa of the nose and paranasal sinuses. While benign in itself, it is quite often spiteful. Who is most at risk of developing inverted papilloma? What are the symptoms of an inverted papilloma and how is it treated?

Inverted papillomais one of the most common, next to osteoma, benign neoplasms of the paranasal sinuses, especially maxillary. It develops from the remains of Schneider's membrane (hence it is sometimes calledSchneider papilloma ) found at the embryonic stage, which is located on the border of the nose and paranasal sinuses.

The changed epithelium begins to grow with fingerlike protrusions into the stroma, not the center of the nose, hence its name: inverted papilloma. It has the appearance of a rough, polycyclic nodule, gray-pink in color ( although it is difficult to see by yourself). It grows slowly but aggressively, destroying the surrounding tissues by pressure and infiltration. Importantly, it affects almost exclusively the area of ​​the sinuses, the lateral nasal cavity and the middle turbinate (in a few cases of the oral cavity), and does not metastasize, while quite often (3.7-14%) it becomes malignant - it turns into squamous cell carcinoma. Inverted papilloma affects men more often, in the age range of 35-60 years.

How does inverted papilloma develop?

Inverted papilloma is still the subject of research by scientists. Most likely it is of viral origin. Specifically, it is HPV types 6, 11, 16, 18, the latter two having a particular tendency to become malignant.

Papillomas are more common in people who spend a lot of time in contact with smoke and dust. Chronic sinusitis also promotes papilloma formation. Although it was once believed that also cigarette smokers and alcoholics had a higher risk of inverted papilloma, this is not confirmed in the statistics.

Inverted papilloma symptoms

Unfortunately, these symptoms are not specific. They closely resemble sinusitis and it may take a long time to be properly diagnosed.

  • increasing, one-sided (less often two-sided) blockage of pipesnasal passages; papilloma, which occurs in both nasal cavities simultaneously, accounts for only 5 percent of cases
  • mucus or purulent discharge from the nose
  • headaches
  • recurrent sinusitis
  • nose bleed
  • palpable lump in the nose

Inverted papilloma: diagnosis

Computed tomography does not give an unambiguous image, much more effective in the case of inverted papilloma is magnetic resonance and endoscopic examination of the inside of the nasal cavity. The final diagnosis is made on the basis of the histopathological examination.

Inverted papilloma treatment

This change can only be treated surgically. It is very ungrateful and difficult to remove thoroughly because it grows firmly into the surrounding tissues, even into the bone, and destroys them. And the basis for the success of the operation is the removal of the entire papilloma with a large margin of he althy tissue. Due to the structure of the lesion, as well as its location, it often happens that the doctor leaves a fragment of it, which is why the papilloma has a tendency to grow back.

The operation to remove an inverted papilloma is performed endoscopically, especially when it comes to small lesions. It is currently the most modern technique and is increasingly used in such cases. However, still the papilloma is operated on from the external access, which is related to cutting the skin of the face or with an incision from the oral cavity. The operation is performed under general anesthesia.

Due to the high probability of regrowth , after the surgery, the patient should regularly, for two years, report to the ENT inspection in order to detect any relapse early. Only after two years of observation, if nothing grows back, can the operation be considered successful and treatment is completed.According to various authors, the probability varies greatly: from 3.6% to 50% after endoscopic surgery and about 13% after extra-nasal surgery.

Category:

Infectious diseases