Inverted papillomas are nasal tumors that originate in the mucosal membrane of the nasal cavity and paranasal sinuses.
Papillomas are benign epithelial tumors that grow outward in fingerlike projections. In inverted papillomas, these projections grow inward and into the underlying bone. These tumors are locally aggressive, often recur, and can become malignant (cancerous). Squamous cell carcinoma is the most common malignancy associated with inverted papillomas.
Symptoms may include a runny nose, nasal obstruction, sinus infections, headaches, and facial pain.
The preferred treatment at UPMC for treating inverted papilloma is the Endoscopic Endonasal Approach (EEA). This innovative technique involves using the nose and nasal cavities to remove the tumors. EEA offers the benefits of no incisions to heal, no disfigurement to the patient, and a shorter recovery time.
Most inverted papillomas can be found during a physical examination of the nasal cavity. They have a reddish-grey appearance and may bleed when touched. The septum may be bowed by the mass. Facial swelling and proptosis (bulging of the eyes) may accompany lesions that have expanded considerably.
During the physical exam, your doctor will ask about any symptoms you are having.
Symptoms may include:
- nasal obstruction, usually one-sided
- rhinorrhea (runny nose)
- epistaxis (nosebleed)
- facial pain
- loss of sense of smell
- frontal headache
Imaging studies reveal the extent to which the tumors have spread and the degree of bone destruction. An MRI is preferred because it allows inverted papillomas to be better distinguished from other types of lesions.
Biopsy is necessary to make a definitive diagnosis.
Surgery is the primary treatment for inverted papillomas. Because of high recurrence rates (40 to 80 percent), early, aggressive surgery usually is recommended.
Inverted papillomas of the sinuses, nasal cavity, and of the skull base can be approached directly by using the Endoscopic Endonasal Approach (EEA). This approach allows surgeons to see and access the tumor well without making incisions to the face or skull. EEA offers the benefits of no incisions to heal, no disfigurement to the patient, and a shorter recovery time.
Endoscopic approaches such as EEA have good success rates in preventing recurrence and better cosmetic outcomes than traditional open surgical approaches.