Sinonasal Inverted Papilloma: A Narrative Review
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Sinonasal Inverted Papilloma: A Narrative Review Ila B. Upadhya1 • Kartika Rao1
Received: 23 June 2020 / Accepted: 20 August 2020 Ó Association of Otolaryngologists of India 2020
Abstract Inverted papilloma (IP) is a relatively rare sinonasal benign lesion, peculiar in its etiology, clinical presentation and treatment. Its resemblance to other sinonasal pathologies and varied approaches, makes it an interesting disease. Recently there have been several advances in the management of IP. This article aims to summarize the contemporary developments thus enabling the readers to understand the years of research behind IP. To integrate the available literature on IP and study the current scenario in its management. A comprehensive literature review was done on Google Scholar and PubMed database using the following key words: ‘‘inverted papilloma’’, ‘‘Schneiderian’’, ‘‘sinonasal’’, ‘‘medial maxillectomy’’. Articles published in English were used. Articles published till May 2020 were reviewed. Years of research have aimed to gain more information regarding the epidemiology, histopathology, staging systems and surgical management of IP. To briefly summarize the research so far, it is safe to say that there exists an association between Human Papilloma Virus and IP. The Krouse staging system is the most commonly used. The treatment itself has changed from a conservative approach to a more aggressive excision with or without external approach and with or without chemoradiotherapy. In IP, whether or not associated with SCC, complete surgical removal of the tumour is advocated as the treatment of choice. With the advancements in endoscopic technique, surgeons have been using it to their advantage for the surgical evaluation and cure of IP, depending upon the stage. Endoscopic treatment is & Kartika Rao [email protected] 1
preferred, whereas for lesions less accessible endoscopically, or in those with peripheral extension, open surgery is indicated. Every patient requires counselling before discharge and thorough examination during the follow-up to detect any evidence of recurrence. Keywords Inverted papilloma Schneiderian papilloma Lateral rhinotomy Endoscopic modified Medial maxillectomy
Introduction IP was first described by Ward, 150 years ago as a follicular tumour [1]. In 1938, Ringertz recognized the endophytic growth pattern and introduced the term ‘‘inverted papilloma’’ [1]. It was Hyams who, in 1971 proposed that they be subclassified into three types, inverted, fungiform and cylindrical [2]. In 1991, the World Health Organization (WHO) classified the sinonasal papilloma into 3 distinct histopathological subtypes: exophytic, inverted, and oncocytic [3]. Stammberger was the first to report the endoscopic treatment of IP in the year 1981 [1]. It was named as Schneiderian papilloma in honour of C. Victor Schneider, who in the 1660 s identified the origin of the nasal mucosa from ectoderm [4]. Of the three types, IP and exophytic papillomas are the most commonly diagnosed subtypes, each
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