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Indian Journal of Otolaryngology and Head & Neck Surgery logoLink to Indian Journal of Otolaryngology and Head & Neck Surgery
. 2007 Dec 11;59(4):369–373. doi: 10.1007/s12070-007-0105-3

Bilateral aggressive inverted papillomas: A changing scenario

Naresh K Panda 1,✉, K Saravanan 1, R K Verma 1, Vankalakunti Mahesha 2
PMCID: PMC3452250  PMID: 23120477

Abstract

Objectives

The ideal management of bilateral, recurrent inverted papillomas is intriguing and often controversial. We describe the ideal management of such tumors.

Design

Retrospective, case series

Methods

The three patients in this series inspite of several surgical procedures in the past had recurrences and behaved in an aggressive fashion. The patients underwent surgical excision by either bilateral lateral rhinotomy, midfacial degloving or craniofacial approaches.

Results

One patient who underwent excision by midfacial degloving approach had recurrence. This was removed by lateral rhinotomy approach. Two patients were subjected to radiotherapy due to the presence of mitotic figures on histopathology. All the patients are asymptomatic at 6 months follow-up.

Conclusion

Aggressive inverted papillomas may have varied presentation. They could have multiple recurrences, bilateral presentation or intracranial extension. They can be effectively managed with bilateral lateral rhinotomy or cranio-facial resection. Adjuvant radiotherapy has a role in controlling recurrences.

Keywords: Bilateral papilloma, Intracranial extension, Bilateral lateral rhinotomy

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