Conclusion

The appropriate management of inverting papilloma depends on the size and location of the lesion. The presence of squamous cell carcinoma, skull base erosion, or intracranial extension or distant metastasis mandates more aggressive therapy. Using biopsy-controlled resection, there is a role for endoscopic management of limited lesions. Recurrent lesions have a higher incidence of associated carcinoma. Thus, the procedure selected should permit complete resection of the tumor at the first attempt. We have developed an algorithm to provide an organized approach for managing inverting papillomas (Figure 6-1). Whenever there is a question in the clinician's mind, the next higher approach should be selected.

Figure 6-1 Management algorithm for inverting papillomas.

BZ Spencer and Schaefer

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