SINONASAL PAPILLOMAS - A REPORT OF 82 CASES IN COPENHAGEN COUNTY, INCLUDING A LONGITUDINAL EPIDEMIOLOGIC AND CLINICAL-STUDY

The present epidemiological and clinical study comprises 82 patients w ith sinonasal papillomas diagnosed from 1975 to 1993. Histology showed 58 cases of inverted papillomas including 5 cases of associated carci noma, 19 cases of exophytic papilloma, and 5 cases of columnar cell pa pilloma. The incidence of sinonasal papillomas in Copenhagen County wa s 0.74 per 100,000 inhabitants per year. The inverted and columnar cel l papillomas were typically located in the middle meatus with a varyin g degree of involvement of the adjacent sinuses. The exophytic papillo mas were predominantly located multicentrically on the nasal septum. G ood results of treatment, especially with regard to inverted papilloma s, were not correlated to the aggressiveness of surgery. A lateral rhi notomy with medial maxillectomy was performed as primary surgery in 28 patients. In 50% of these patients there were recurrences. The prelim inary results of endonasal endoscopic surgery revealed a high success rate, i.e., no recurrences in 5 cases so far. The septal papillomas we re typically resected by a simple endonasal procedure. There were recu rrences in 66% of these cases. The midfacial degloving procedure may b e advocated instead of or as a supplement to the lateral rhinotomy if the tumor cannot be visualized sufficiently by endoscopy. Smoking may dispose to sinonasal papillomas.