ENT · Nasal and PNS Tumors

Inverted papilloma (Schneiderian papilloma, endophytic type) of the nasal cavity and paranasal sinuses is associated with all of the following EXCEPT:

  • A Risk of malignant transformation to squamous cell carcinoma in 5–15% of cases
  • B Association with HPV types 6 and 11 (low-risk) and occasionally HPV 16/18 in malignant transformation
  • C The treatment of choice is endoscopic excision with wide local margins, avoiding medial maxillectomy
  • D Origin from the Schneiderian membrane (ectodermally derived) — predominantly from the lateral nasal wall and middle meatus
Correct answer: C. The treatment of choice is endoscopic excision with wide local margins, avoiding medial maxillectomy

Explanation

Inverted papilloma has a high recurrence rate when excised inadequately. The standard treatment is radical excision, traditionally via lateral rhinotomy and medial maxillectomy (Caldwell-Luc, medial maxillectomy); however, endoscopic resection with wide clearance and generous bone removal (Krouse staging-guided endoscopic approaches) has become the gold standard at experienced centres, with equivalent recurrence rates if periosteum/bone of origin is removed. Simple endoscopic polypectomy without resection of the bone origin has high recurrence. Complete removal including the underlying bone is mandatory — endoscopic medial maxillectomy when needed is appropriate.

Reference: Dhingra Diseases of Ear, Nose and Throat, 7th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.

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