Overview
Benign inverted sinonasal papilloma (SNIP) is a rare, locally invasive tumor arising from the Schneiderian epithelium of the nasal cavity and paranasal sinuses, typically presenting as a unilateral, firm mass 1.Diagnosis
Clinical Presentation: Unilateral nasal obstruction, epistaxis, and facial pain 1.
Imaging: CT or MRI showing a polypoid mass with possible bony erosion 1.
Histopathology: Definitive diagnosis requires histopathological examination showing inverted growth pattern 1.
HPV Testing: Polymerase chain reaction (PCR) or in-situ hybridization (ISH) to detect HPV presence 1.Management
Surgical Excision: Primary treatment, often requiring endoscopic or external approaches depending on tumor size and location 1.
Recurrence Monitoring: Regular follow-up with clinical exams and imaging to monitor for recurrence 1.
HPV-Positive Tumors: Consider increased vigilance for recurrence due to associated higher risk 1.Special Populations
Recurrence Risk: HPV-positive SNIPs may pose a higher recurrence risk regardless of age or comorbidities 1.Key Recommendations
Perform HPV testing via PCR or ISH in all SNIP cases to assess recurrence risk 1 (Evidence: Moderate).
Implement aggressive surgical excision for SNIP with close postoperative monitoring for recurrence 1 (Evidence: Moderate).
Patients with HPV-positive SNIP should be monitored more frequently for potential recurrence compared to HPV-negative cases 1 (Evidence: Moderate).References
1 Alqudrah F, Kota S, Morgan J, Purnell PR, McCormick JP. Human Papilloma Virus Infection and Sinonasal Inverted Papilloma Recurrence: A Meta-Analysis. Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery 2025. link