Sinonasal schneiderian papilloma.
OBJECTIVE
Schneiderian papilloma of the paranasal sinuses is a locally aggressive benign epithelial tumour with malignant potential.


METHODS
A retrospective analysis of 72 patients as seen at our institution from 1978 to 1997 was conducted.


RESULTS
The most frequent symptoms at time of presentation were nasal obstruction, presence of a nasal mass, and nasal discharge. The most common sites of involvement were the maxillary antrum (58.3%), lateral nasal wall (41.7%) and ethmoid sinus (37.5%). Histologic examination confirmed all 72 instances of schneiderian papilloma, with 55/72 (76.4%) being of the inverted type, 13/72 (18.1%) being the fungiform type, and 4/72 (5.5%) being the cylindrical type. An associated malignancy or potential premalignant condition was present in 15 patients (20.8%), with 8 (11.1%) exhibiting dysplastic changes, 4 patients (5.5%) found to have carcinoma in situ, and 3 patients (4.2%) found to have invasive carcinoma. Conservative surgical excision was performed in 37 (51.4%) with more radical surgery, including lateral rhinotomy and medial maxillectomy performed in 35 (48.6%) patients. Recurrence was seen in 17/37 (45.9%) patients treated conservatively compared to 0/35 (0.0%) patients treated aggressively.


CONCLUSIONS
Our results indicate that more aggressive surgery is associated with a more definitive treatment and significantly less recurrence and, as such, is the management of choice in cases of schneiderian papilloma. Furthermore, our results indicate the need for long-term follow-up, and the applicability of sinus endoscopy in doing so.
Department of Otolaryngology, McGill University, Sir Mortimer B. Davis-Jewish General Hospital, Montreal, Quebec.
A
A
Yoskovitch
I
I
Braverman
D
D
Nachtigal
S
S
Frenkiel
L
L
Rochon
M J
MJ
Black
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004724:Endoscopy / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010212:Papilloma / Q000601:surgery*; D010255:Paranasal Sinus Neoplasms / Q000601:surgery*; D012189:Retrospective Studies