Skip to main content
    • Aa
    • Aa

Management of inverted papilloma: review

  • B Attlmayr (a1), S G Derbyshire (a1), A V Kasbekar (a1) and A C Swift (a1)
Abstract Background:

Inverted papilloma is the most common benign tumour affecting the nose. There is a high rate of recurrence and a potential of malignant transformation. This review article aimed to identify the best available management of this pathology today.


A systematic review of the current English-language literature was performed. Only original articles with a minimum follow up of one year and an average follow up of two years were included.


A total of 1385 patients from 16 case series were identified. The total recurrence rate for all patients was 11.5 per cent. Significantly lower recurrence rates were found for procedures using an attachment-oriented excision (recurrence of 6.9 per cent; p = 0.0001) and utilising frozen sections (recurrence of 7.0 per cent; p = 0.0001).


There is a general trend towards endoscopic surgery. There may be some benefit to the use of attachment-oriented surgery and frozen sections. Multi-centred randomised controlled trials are required.

Corresponding author
Address for correspondence: Dr B Attlmayr, ENT Department, Aintree University Hospital, Longmoor Lane, Liverpool L9 7AL, UK Fax: 00 44 151 529 5237 E-mail:
Hide All

Presented as a poster at the 25th Congress of the European Rhinologic Society, 22–26 June 2014, Amsterdam, the Netherlands.

Hide All
3 S Govindaraj , H. Wang Does human papilloma virus play a role in sinonasal inverted papilloma? Curr Opin Otolaryngol Head Neck Surg 2014;22:4751

4 A d'Errico , J Zajacova , A Cacciatore , A Baratti , R Zanelli , S Alfonzo Occupational risk factors for sinonasal inverted papilloma: a case-control study. Occup Environ Med 2013;70:703–8

5 VJ. Lund Optimum management of inverted papilloma. J Laryngol Otol 2000;114:194–7

6 W Lawson , MR Kaufman , HF. Biller Treatment outcomes in the management of inverted papilloma: an analysis of 160 cases. Laryngoscope 2003;113:1548–56

8 T Mackle , G Chambon , R Garrel , M Meieff , L. Crampette Endoscopic treatment of sinonasal papilloma: a 12 year review. Acta Otolaryngol 2008;128:670–4

9 G Waitz , ME. Wigand Results of endoscopic sinus surgery for the treatment of inverted papillomas. Laryngoscope 1992;102:917–22

10 D Tomenzoli , P Castelnuovo , F Pagella , M Berlucchi , L Pianta , G Delù Different endoscopic surgical strategies in the management of inverted papilloma of the sinonasal tract: experience with 47 patients. Laryngoscope 2004;114:193200

11 RP Tufano , ER Thaler , DC Lanza , DW. Kennedy Endoscopic management of inverted papilloma. Am J Rhinol 1999;13:423–6

12 R Landsberg , O Cavel , Y Segev , A Khafif , DM. Fliss Attachment-oriented endoscopic surgical strategy for sinonasal inverted papilloma. Am J Rhinol 2008;22:629–34

13 JM Busquets , PH. Hwang Endoscopic resection of sinonasal inverted papilloma: a meta-analysis. Otolaryngol Head Neck Surg 2006;134:476–82

14 PD Karkos , G Fyrmpas , SC Carrie , AC. Swift Endoscopic versus open surgical interventions for inverted nasal papilloma: a systematic review. Clin Otolaryngol 2006;31:499503

15 D Lombardi , D Tomenzoli , L Buttà , A Bizzoni , D Farina , F Sberze Limitations and complications of endoscopic surgery for treatment for sinonasal inverted papilloma: a reassessment after 212 cases. Head Neck 2011;33:1154–61

18 JH. Krouse Development of a staging system for inverted papilloma. Laryngoscope 2000;110:965–8

19 K Oikawa , Y Furuta , Y Nakamaru , N Oridate , S. Fukuda Preoperative staging and surgical approaches for sinonasal inverted papilloma. Ann Otol Rhinol Laryngol 2007;116:674–80

20 JA Socher , M Cassano , CA Filheiro , P Cassano , A. Felippu Diagnosis and treatment of isolated sphenoid sinus disease: a review of 109 cases. Acta Otolaryngol 2008;128:1004–10

21 C Durucu , T Baglam , E Karatas , S Mumbuc , M. Kanlikama Surgical treatment of inverted papilloma. J Craniofac Surg 2009;20:1985–8

22 RK Weber , JA Werner , T. Hildenbrand Endonasal endoscopic medial maxillectomy with preservation of the inferior turbinate. Am J Rhinol Allergy 2010;24:132–5

23 Q Liu , H Yu , A Minovi , W Wei , D Wang , C Zheng Management of maxillary sinus inverted papilloma via transnasal endoscopic anterior and medial maxillectomy. ORL J Otorhinolaryngol Relat Spec 2010;72:247–51

26 DY Kim , SL Hong , CH Lee , HR Jin , JM Kang , BJ Lee Inverted papilloma of the nasal cavity and paranasal sinuses: a Korean multicenter study. Laryngoscope 2012;122:487–94

27 C Wang , D Han , L. Zhang Modified endoscopic maxillary medial sinusotomy for sinonasal inverted papilloma with attachment to the anterior medial wall of maxillary sinus. ORL J Otorhinolaryngol Relat Spec 2012;74:97101

28 F Lian , H. Juan Different endoscopic strategies in the management of recurrent sinonasal inverted papilloma. J Craniofac Surg 2012;23:44–8

29 W Xiao-Ting , L Peng , W Xiu-Qing , W Hai-Bo , P Wen-Hui , L Bing Factors affecting recurrence of sinonasal inverted papilloma. Eur Arch Otorhinolaryngol 2013;270:1349–53

30 V Sciarretta , IJ Fernandez , P Farneti , E. Pasquini Endoscopic and combined external-transnasal endoscopic approach for the treatment of inverted papilloma: analysis of 110 cases. Eur Arch Otorhinolaryngol 2013;271:1953–9

33 K Syrjänen , S. Syrjänen Detection of human papillomavirus in sinonasal papillomas: systematic review and meta-analysis. Laryngoscope 2013;123:181–92

36 CL Sham , JK Woo , CA van Hasselt , MC. Tong Treatment results of sinonasal inverted papilloma: an 18-year study. Am J Rhinol Allergy 2009;23:203–11

38 OR Hughes , CJ Skilbeck , I Kwame , K Kwa , DI. Choa Suction diathermy as an adjunct to endoscopic removal of inverted papilloma. Laryngoscope 2011;121:997–8

39 MI Syed , J Mennie , AT. Williams Early experience of radio frequency coblation in the management of intranasal and sinus tumors. Laryngoscope 2012;122:436–9

40 Y Zhang , Y Yang , X. Zou Efficacy of 5-aminolevulinic acid photodynamic therapy in treatment of nasal inverted papilloma. Photodiagnosis Photodyn Ther 2013;10:549–51

Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

The Journal of Laryngology & Otology
  • ISSN: 0022-2151
  • EISSN: 1748-5460
  • URL: /core/journals/journal-of-laryngology-and-otology
Please enter your name
Please enter a valid email address
Who would you like to send this to? *



Altmetric attention score

Full text views

Total number of HTML views: 6
Total number of PDF views: 113 *
Loading metrics...

Abstract views

Total abstract views: 650 *
Loading metrics...

* Views captured on Cambridge Core between 9th February 2017 - 26th September 2017. This data will be updated every 24 hours.