Inverted papillomas (IPs) in the nose or the paranasal sinuses exhibit a tendency for rapid growth with bone destruction, a high recurrence rate, and an association with malignancy, requiring early diagnosis and aggressive surgical therapy. A number of operative approaches have been reported in the literature, with greatly varying results. Furthermore, the incidence of IP and the association with carcinoma are not well-established. In this study, we present a series of 42 patients with IP. Drawing from the resources of two institutes of pathology, we reviewed all specimens of nasal cavity or paranasal sinus tissue taken between the years 1975 and 1986, and performed a thorough follow-up of all IP patients. The incidence was found to be 0.6 cases per 100,000 inhabitants per year in a well-defined representative geographic region. Two patients had concomitant carcinoma. When the initial surgical approach was lateral rhinotomy, the recurrence rate was 50%. This was not significantly different from that noted following excision through a sinusectomy (62%) or simple endonasal excision (43%). However, initial procedures were selected individually, mainly on the basis of tumor size and location. Accordingly, a limited procedure is considered justified even in cases with lateral lesions, if the tumor is sufficiently visible and confined. In other cases, lateral rhinotomy is required. Septal IPs are often detected at an early stage and are therefore often amenable to local excision.

Adult↗

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Radiologic aspects of inverted papilloma.

A series of 42 patients with inverted papilloma is presented. Of these, 38 patients had radiologic examinations. Thirty patients had comparable radiologic examinations in the form of X-ray of the sinuses and/or tomography and/or CT scan. The preoperative findings were compared and related to the extent of the tumor at surgery. Clinical examination combined with CT appears to be the optimal preoperative procedure. Follow-up should include CT in order to allow comparison with postoperative status and, preferably, also with preoperative radiologic findings.

Biopsy↗

PubMedDate not supplied

Early and late side effects of water-soluble contrast media for myelography and cisternography: a short review.

Acute and chronic neurotoxicities of the ionic contrast media Conray, Dimer X, Dimer X and a steroid, and a nonionic contrast medium metrizamide (Amipaque) are reviewed. All ionic media induced late arachnoiditis potentiated by intrathecal steroids. Amipaque did not induce late arachnoiditis, but it produced a number of acute side effects. Myelography in patients given a phenothiazine (levomepromazine) was associated with a decreased incidence of side effects compared with a nonmedicated group.

Arachnoiditis↗