INTRODUCTIONSinonasal papillomas represent 0.5%‐4% of all sinonasal tumors. The first real distinction between papillomas and polyps was made by Kramer and Som in 1935. To date, 3 types of sinonasal papillomas, also known as Schneiderian papillomas, have been described histologically: inverted, exophytic, and oncocytic. The exophytic papilloma is usually diagnosed after nasal obstruction or epistaxis. The macroscopic appearance is that of a whitish papillomatous tumor with a wide implantation base (Figure ). The most common localization is the anterior wall of the septum, a transition zone between a cylindrical pseudostratified squamous epithelium and mucosal respiratory type. Microscopically, they are composed of papillary fronds with a fibrovascular core covered by epithelium of various aspects: squamous to transitional, ciliated, and pseudostratified columnar (Figure ). The involvement of the human papillomavirus (HPV) types 6 and 11 in the pathogenesis of exophytic papilloma is suggested by the presence of koilocytes on pathological examination, whereas polymerase chain reaction (PCR) analysis of samples exhibit different HPV genotypes. Although inverted papillomas have been codified and treatment approaches standardized, the treatment of pure exophytic papilloma is poorly described. They are generally removed by endonasal surgery under endoscopic guidance with a recurrence rate of 22%. The purpose of
Head & Neck: Journal for the Sciences & Specialties of the Head and Neck – Wiley
Published: Jan 1, 2018
Keywords: ; ; ; ;
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