An inverting papilloma is a fast-growing but harmless tumour that can occur in the mucus membranes that line the nose or in the sinuses adjacent to the nose. There are 4 sinuses at risk for developing an inverting papilloma, also called the paranasal sinuses. Located above, below and between the eyes, a tumour here grows into the nearest bone, adding to discomfort. Although inverting papilloma is usually benign, in rare cases the tumour can become cancerous. For this reason, the course of treatment is very aggressive.
Common symptoms of inverting papilloma include:
Many people with inverting papilloma never experience symptoms at all, and the inverting papilloma is discovered at a routine checkup or upon examination for a different nasal or sinus issue.
There is no known cause of inverting papilloma. Allergies, chronic sinus infection, and viral upper respiratory infections have been suggested as possible causes. However, there is not enough evidence to confirm that one of these actually causes inverting papilloma.
Associated risk factors include being assigned male at birth and having human papilloma virus (HPV). Inverting papilloma is seen more often in men. Additionally, while there is no evidence that HPV causes inverting papilloma, it is thought to play a role in the development of inverting papilloma. This puts those with HPV slightly more at risk for developing inverting papilloma.
Symptoms of inverting papilloma are common to many nasal and sinus related diseases. The tools used to diagnose inverting papilloma are common to many nasal and sinus related diseases with the same set of symptoms. Whether your doctor suspects inverting papilloma or is simply trying to rule it out, this set of diagnostic tools, combined with your medical history and current symptoms, will allow your doctor to make an accurate diagnosis.
Complications of inverting papilloma include this typically benign tumour turning cancerous, damage to the bone structure around the sinuses, and reoccurrence. Due to the aggressiveness of inverting papilloma, it’s very common for it to come back if not properly removed the first time.
Currently, the only treatment option for inverting papilloma is surgery. Nasal endoscopy is typically an effective surgical option. Similar to when an endoscope is being used for diagnosis, a surgeon will insert the endoscope, a small, flexible tube up into the nasal passage or sinus where the inverting papilloma is.
A camera and a light are attached to the endoscope, and a tool to remove the tumour can be passed through the endoscope. The tumour will be removed where it attaches. After removal of the tumour, the bone underneath is treated to prevent the inverting papilloma from coming back. In rare cases, nasal endoscopy is not an option and radiation and chemotherapy are used.