Radiographic Assessment of Inverted Papilloma

Abstract

Radiographic studies were reviewed from a group of 24 patients with biopsy-proven inverted papilloma of the nasal cavity or paranasal sinuses. Thirty-two cases of computed tomography (CT), 17 cases of plain sinus radiography, four cases of polytomography, and three cases of magnetic resonance imaging (MRI) were retrieved for analysis. Although no preoperative MRI examinations were available for comparison, CT was the most helpful study for evaluation of primary, nonrecurrent inverted papilloma, demonstrating disease-related abnormalities in 90% of the cases. While no CT finding was pathognomonic, findings that helped to distinguish inverted papilloma from benign nasal polyposis included predominantly unilateral involvement (90%) and frequent unilateral bony remodeling (40%). Plain sinus X-rays were abnormal in 70% of cases of primary tumor, with all positive studies showing nonspecific unilateral opacification of the maxillary antrum. Both CT and MRI defined the extent of histologically proven recurrent disease, although it was impossible to radiographically distinguish recurrent disease from postoperative scar tissue or mucoperiosteal thickening.