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Suggest Treatment For Inverted Papilloma
Question: Hi, I am XXXX , 43 year old male. I had difficulties in breathing and occassional bleeding from right nasal in Year 2007-2008. On investigation, inflammatory polyps were found in my right nasal area and the polyps were found to be benign then. I underwent an operation in Dec 2008. But again this year,2014, the polyps had recurred and caused 4-5 times nasal bleeding . On investigation, the polyps were found to be in infected condition. CT scan also confirmed the growth of the lesions in the right nasal tract as "RIGHT ANTROCHONAL POLYP". So i had to undergo endoscopic nasal surgery second time in Aug 2014. Biopsy report taken on the tissue samples. Biopsy (Histopathological) evaluation ruled out malignancy at this point and diagnosed the condition as "Inverted Papilloma (IP)-ethimoidal sinus".
Though the doctor who operated second time mentioned that he has done reasonably deep excision but does not rule out the recurrence. He also opined that he would have done deep root excision if he knew it was IP.
I do not have any Sugar, BP but taking cholestral medications.
So my questions now are
1. What is IP? Is this a disease? Is this a recurring disease ?
2. Will this IP lead to malignancy in future?
3. In the current scenario, What can cause the malignancy? What precaution needs to be taken from now?
4. What are the treatment options for IP ?
4.1 Can we keep the growth in check by using external medicine/sterioid application ?
4.2 If surgery the only option, is there a way to prevent the recurrence to avoid future surgeries ?
5. Though it is not currently malignant, do you advise any kind of definitive radiotherapy procedure now to avoid the recurrence and malignance complications in future ?
5.1 Are there any associated complications, if I take this path?
6. How to keep the polyps (in case of recurrence) infection free? I catch common cold regularly and fear that it can cause infections on the areas infected with IP.
Also CT scan revealed 'S' shaped DNS.
7. In the last one year i have lost around 5 kgs. Is this related to IP and bleeding?
7.1 Or Is this related to malignancy in other area? How to check it ?
8. Also advise the expert hospital and doctors (in XXXXXXX XXXXXXX chennai) , who can help me in this case further in terms experience and with right treatment options.
Though the doctor who operated second time mentioned that he has done reasonably deep excision but does not rule out the recurrence. He also opined that he would have done deep root excision if he knew it was IP.
I do not have any Sugar, BP but taking cholestral medications.
So my questions now are
1. What is IP? Is this a disease? Is this a recurring disease ?
2. Will this IP lead to malignancy in future?
3. In the current scenario, What can cause the malignancy? What precaution needs to be taken from now?
4. What are the treatment options for IP ?
4.1 Can we keep the growth in check by using external medicine/sterioid application ?
4.2 If surgery the only option, is there a way to prevent the recurrence to avoid future surgeries ?
5. Though it is not currently malignant, do you advise any kind of definitive radiotherapy procedure now to avoid the recurrence and malignance complications in future ?
5.1 Are there any associated complications, if I take this path?
6. How to keep the polyps (in case of recurrence) infection free? I catch common cold regularly and fear that it can cause infections on the areas infected with IP.
Also CT scan revealed 'S' shaped DNS.
7. In the last one year i have lost around 5 kgs. Is this related to IP and bleeding?
7.1 Or Is this related to malignancy in other area? How to check it ?
8. Also advise the expert hospital and doctors (in XXXXXXX XXXXXXX chennai) , who can help me in this case further in terms experience and with right treatment options.
Brief Answer:
IP is inverted papilloma
Detailed Answer:
Hi, thanks for your query.
As far as my knowledge holds, IP (Inverted Papilloma) is a benign papilloma or growth of the nose.
It's usually seen in male female ratio of 3:1.
Seen in 30 to 50 yrs of age.
3 types are foung namely fungifirm, inverted, and cylindrical.
Present as a polyp or nose bleeding.
Arises from lateral wall of nose and spreads to the sinuses.
It can turn into cancer.
There is no treatment to prevent it from converting into cancer. Wide excision is the only treatment option. There is no medicine to stop its conversion.
Rate of recurrence by about 70%. Radiotherapy of 6000 rads can be given for 6 weeks. It depends on the staging of the disease. This can prevents its malignant transformation to some extent.
For you since it is seen in ethmoidal sinus, wide excision followed by RD would be better option.
Your weight cannot be attributed to this disease.
Regular checkups can help to get treated at early stages.
Dr. XXXXXXX haldipur of chord road hospital, XXXXXXX Alternatively, any institutions with medical college attached can help you with this.
KKR institute XXXXXXX are recommended.
You can discuss this with your doctor and be evaluated.
Hope my answers have helped you. Thanks.
IP is inverted papilloma
Detailed Answer:
Hi, thanks for your query.
As far as my knowledge holds, IP (Inverted Papilloma) is a benign papilloma or growth of the nose.
It's usually seen in male female ratio of 3:1.
Seen in 30 to 50 yrs of age.
3 types are foung namely fungifirm, inverted, and cylindrical.
Present as a polyp or nose bleeding.
Arises from lateral wall of nose and spreads to the sinuses.
It can turn into cancer.
There is no treatment to prevent it from converting into cancer. Wide excision is the only treatment option. There is no medicine to stop its conversion.
Rate of recurrence by about 70%. Radiotherapy of 6000 rads can be given for 6 weeks. It depends on the staging of the disease. This can prevents its malignant transformation to some extent.
For you since it is seen in ethmoidal sinus, wide excision followed by RD would be better option.
Your weight cannot be attributed to this disease.
Regular checkups can help to get treated at early stages.
Dr. XXXXXXX haldipur of chord road hospital, XXXXXXX Alternatively, any institutions with medical college attached can help you with this.
KKR institute XXXXXXX are recommended.
You can discuss this with your doctor and be evaluated.
Hope my answers have helped you. Thanks.
Note: Consult an experienced Otolaryngologist / ENT Specialist online for further follow up on ear, nose, and throat issues - Book a Call now.
Above answer was peer-reviewed by :
Dr. Shanthi.E
Answered by
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