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Considerations in Treatment

Gayle E. Woodson, MD, FRCS(C); K. Thomas Robbins, MD, FRCS(C); Leslie Michaels, MD, FRCPath, FRCP(C)

Arch Otolaryngol. 1985;111(12):806-811.

Abstract
• Inverted papilloma is notorious for recurrence and occasional association with malignancy, leading most authors to recommend lateral rhinotomy as the initial surgical approach in all cases; however, conservative surgery has been reported effective in selected cases. To assess the role of conservative procedures, 90 cases of inverted papilloma were retrospectively reviewed. Associated malignancy was rare. Conservative surgery was successful in controlling some cases, but often required two or three operations. All patients with clear sinus films were cured by a single procedure. Abnormal mitotic activity was seen in some aggressive lesions and some associated with malignancy. The surgical exposure in inverted papilloma should be adequate to ensure complete excision. Selected patients with localized disease can be satisfactorily managed by conservative procedures if they are carefully followed. All tissue should be inspected for possible malignancy.

(Arch Otolaryngol 1985;111:806-811)

Author Affiliations
From the Department of Otorhinolaryngology and Communicative Sciences, Baylor College of Medicine, Houston (Dr Woodson); the Department of Otolaryngology—Head and Neck Surgery, University of Texas Health Science Center at Houston (Dr Robbins); and the Department of Pathology and Bacteriology, Institute of Laryngology and Otology, London (Dr Michaels). Dr Robbins is now with M. D. Anderson Hospital and Tumor Institute, Houston.

Footnotes
Accepted for publication April 16, 1985.

Read before the Royal Society of Medicine, London, March 4, 1983.

Reprint requests to Department of Otorhinolaryngology and Communicative Sciences, Baylor College of Medicine, 1 Baylor Plaza, Houston, TX 77030 (Dr Woodson).

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