Sinonasal Inverted Papilloma

N Thapa,B Pradhan

doi:10.3126/joim.v34i2.9044

Abstract

Introduction: Sinonasal inverted papilloma is a rare tumour comprising about 0.5-4% of total nose and paranasal sinus tumours. Though various factors have been implicated its exact cause is unknown. This longitudinal, prospective study was carried out to nd out demographical prole, association of this tumour with smoking, occupation, variation with ethnic races and outcome of surgery. Methods: This study was carried out in the department of ENT-HNS, Tribhuvan University Teaching Hospital, Maharajgunj, Kathmandu from April, 2005 to March, 2011. Result: Out of 34 patients, there were 25 male and 9 female with ratio of 2.78:1. Age of the patients ranged from 14-76 years with median age of 51.5±2.74 SE years. Disease was more common in 4th to 7th decade. It was common in farmers (20). Eighteen patients were smoker and 16 nonsmoker. The disease was more common in mongoloids than in Indo-aryans. Out of 16 patients having stage III disease, 9 were smoker and 7 nonsmoker. Eighteen patients underwent endoscopic medial maxillectomy and 15 patients underwent medial maxillectomy via lateral rhinotomy approach. One patient who had bilateral disease underwent medial maxillectomy via lateral rhinotomy on the left side and endoscopically on the right side. There was recurrence of tumour in 2 patients who underwent surgery via lateral rhinotomy approach whereas in 1 patient who underwent surgery endoscopically. Conclusion: This study showed that sinonasal inverted papilloma was common in mongoloids than in Indo-aryans and farmers but no association with smoking. Endoscopic medial maxillectomy has less reccurence of tumour in comparison to lateral rhinotomy approach. DOI: http://dx.doi.org/10.3126/joim.v34i2.9044 Journal of Institute of Medicine August, 2012; 34:2 10-13

Highlights

Sinonasal inverted papilloma is a rare tumour comprising about 0.5-4% of total nose and paranasal sinus tumours
This study showed that sinonasal inverted papilloma was common in mongoloids than in Indo-aryans and farmers but no association with smoking
It was first described by Ward in 1854 and Billroth in 1855.2 Its typical histological description was given by Ringertz in 1938.3 It comprises about 0.5-4% of total nose and paranasal sinus tumours.[1]. It is a benign tumour but has a high propensity of recurrence and association with synchronous and metachronous malignancies.[4]. It occurs more commonly in male than in females with ratio of 3:1 and most patients are usually diagnosed in the 5th to 7th decades with average age of 53 years though it has been reported in children, adolescents and elderly with age ranging from 3-89 years.[1,5]

Summary

Introduction

Sinonasal inverted papilloma is a rare tumour comprising about 0.5-4% of total nose and paranasal sinus tumours. It is known by various names as Schneiderian papilloma, epithelial papilloma, Ringertz’s tumour, transitional cell papilloma, villiform cancer, Ewing’s papilloma etc.[1] It was first described by Ward in 1854 and Billroth in 1855.2 Its typical histological description was given by Ringertz in 1938.3 It comprises about 0.5-4% of total nose and paranasal sinus tumours.[1] It is a benign tumour but has a high propensity of recurrence and association with synchronous and metachronous malignancies.[4] It occurs more commonly in male than in females with ratio of 3:1 and most patients are usually diagnosed in the 5th to 7th decades with average age of 53 years though it has been reported in children, adolescents and elderly with age ranging from 3-89 years.[1,5].

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