Best of five
- A. Repeated office debulking only
- B. Complete endoscopic excision with treatment of the attachment site and long-term surveillance
- C. Radiotherapy for every benign lesion
- D. No follow-up after excision
- E. Bilateral turbinectomy
FRCS (ORL-HNS) · SECTION 1 SBA
Sinonasal inverted papilloma
A patient has unilateral nasal obstruction and a cerebriform mass arising from the lateral nasal wall. Biopsy shows inverted papilloma. What management principle is most appropriate?
B. Complete endoscopic excision with treatment of the attachment site and long-term surveillance
Inverted papilloma has a characteristic attachment, recurrence risk and association with synchronous or metachronous carcinoma. Mapping and treating the attachment is more important than simple debulking.
Why every option is right or wrong
A. Repeated office debulking only: This leaves the attachment and promotes recurrence.
B. Complete endoscopic excision with treatment of the attachment site and long-term surveillance: Inverted papilloma has a characteristic attachment, recurrence risk and association with synchronous or metachronous carcinoma. Mapping and treating the attachment is more important than simple debulking.
C. Radiotherapy for every benign lesion: Primary benign disease is usually treated surgically.
D. No follow-up after excision: Late recurrence and malignant change can occur.
E. Bilateral turbinectomy: Disease is unilateral and site-specific.
What if the scenario changed?
If biopsy demonstrated invasive squamous carcinoma, oncological staging and a cancer resection strategy would supersede benign-lesion management.
Independent Clinora educational preparation material; not official JCIE content, an accredited programme, clinical advice, or a substitute for current guidance, local policy and specialist judgement.
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