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Inverted papillomatosis of the nose: Treatment, symptoms, advice and help

About inverted papillomatosis of the nose

Inverted papilloma of the nose is a benign tumour involving the mucosal (inner) lining of the nose and paranasal sinus cavities. As the name suggests, the surface epithelial cells grow inward (rather than outward) into the underlying supporting tissue like bone. These tumours are unique in history, biology and location. Though these tumours are slow growing and benign, they may progress to malignant tumours, in a few individuals.

Inverted papillomatosis of the nose: Incidence, age and sex

They comprise 0.5 – 4% of all primary nasal tumours with an incidence of 0.74 to 1.5 cases per 100000 per year. Men are affected 4 times more often than women. It is more commonly seen in individuals in the age group of 50-70 years. They are rare in children and younger adults.

Signs and symptoms of inverted papillomatosis of the nose: Diagnosis

The condition characteristically affects only one side of the nose. Very rarely, does this tumour arise on both sides of nose. The common symptoms include unilateral nasal obstruction, nasal bleed, discharge, headache and facial pain.

Physical examination by a specialist may reveal a mass filling on one side of the nasal cavity which may be irregular, reddish grey in colour and may bleed when touched. The mass may push the nasal septum to the other side. Bulging out of eye balls and facial swellings may also be seen which may result from expansion of the papilloma.

Imaging tests like CT or MRI scans is essential to determine the extent of the papilloma and also to differentiate it from other mass lesions. An invasive test like biopsy may be needed to establish the diagnosis. This procedure requires the removal of a small tissue sample of the mass which is then studied microscopically in a laboratory to detect any cancerous lesion.

Causes and prevention of inverted papillomatosis of the nose

The aetiology remains unconfirmed. Certain triggering factors include nasal allergies, chronic sinusitis, airborne pollutants and viral infection with human papilloma virus. There is no specific preventive measure.

Inverted papillomatosis of the nose: Complications

The complications of inverted papilloma of the nose include malignant transformation of the benign growth. This may subsequently progress to destroy the adjacent bones, thereby resulting in displacement of the eye.

Inverted papillomatosis of the nose: Treatment

The only treatment modality for this condition is surgical approach. Medical treatment plays no role in management. Surgery provides cure in most of the cases. Surgery involves removal of the lesion through an endoscopic approach from one side of nose. This procedure is termed as Endoscopic Endonasal Approach which provides fast recovery time with minimal side affects. The success rate is fairly good; however the recurrence of these tumours is high. Thus a long-term follow up is recommended in affected individuals.