A 45-year-old man undergoes endoscopic excision of a unilateral nasal mass diagnosed as inverted papilloma. Which factor most strongly predicts recurrence after surgery?

• A Patient age at presentation
• B Use of image guidance during surgery
• C Presence of nasal polyposis elsewhere in the cavity
• D Incomplete removal of the site of mucosal attachment ✓

Explanation

Recurrence of inverted (Schneiderian) papilloma is driven by residual disease at the site of attachment, so modern surgery aims at en bloc or meticulous drilling of the attachment, typically on the lateral nasal wall or maxillary sinus. Recurrence rates fall substantially when the attachment is completely addressed. Age, coexisting inflammatory polyps and use of navigation do not determine recurrence, and image guidance actually improves completeness of resection.

Reference: Cummings Otolaryngology Head and Neck Surgery, 7th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.