Schneiderian papilloma of the nose and paranasal sinuses : the University of Ottawa experience

: Schneiderian papillomata of the nose and the paranasal sinuses are uncommon neoplasms. Although histologically benign, malignancy can occur. The likely etiologic agent is the human papilloma virus. We reviewed the cases treated at University of Ottawa-affiliated hospitals from 1969-1989. There were 35 patients consisting of 26 men and nine women with an average age of 55.8 years. The most common presenting symptom was unilateral nasal obstruction (71.4%). This was caused in most cases by an ipsilateral polypoid mass (82.9%). CT scan study was helpful in delineating the size and extent of the lesion. Four cases of malignancy were found (11.4%). Whether malignant transformation had occurred or whether a synchronous or metachronous malignancy had been serendipitously discovered is open to debate. Thorough examination with biopsy is mandatory to obtain a definitive histologic diagnosis. Intranasal papilloma-plucking (polypectomy) is useful for biopsy purposes but grossly inadequate as definitive treatment. The high recurrence rate is due to inadequate resection. Radical surgery consisting of medial maxillectomy via the lateral rhinotomy approach has the lowest recurrence rate (7.1%) and is the treatment of choice.