Inverted Papilloma – A Rare Nasal Tumour That Needs Specialist Care
An inverted papilloma is an uncommon but important growth that develops from the lining of the nose and sinuses. Although it is a benign (non-cancerous) tumour, it behaves differently from nasal polyps and requires careful specialist assessment and treatment.
At Hampshire ENT Clinics and Medicana Winchester, we regularly assess and manage patients with inverted papilloma from Portsmouth, Southampton, Winchester and Salisbury, using modern imaging and advanced endoscopic sinus surgery techniques.
👃 What Is an Inverted Papilloma?
An inverted papilloma is a benign tumour arising from the Schneiderian mucosa, the specialised lining of the nasal cavity and sinuses.
Unlike nasal polyps, inverted papillomas:
Grow into underlying tissue (“inverted” growth pattern)
Can erode bone
Have a high recurrence rate if not completely removed
Carry a small but significant risk of associated cancer
Because of this behaviour, they are treated very differently from inflammatory nasal polyps.
📌 Common Symptoms of Inverted Papilloma
Symptoms often develop gradually and may include:
Persistent one-sided nasal blockage
Nasal discharge (sometimes blood-stained)
Reduced sense of smell
Recurrent sinus infections on one side
Facial pressure or pain
Nosebleeds
Symptoms are often unilateral, which is an important red flag in ENT assessment.
🔍 How Is Inverted Papilloma Diagnosed?
Diagnosis usually involves a combination of:
1. Nasal Endoscopy
A camera examination allows direct visualisation of the lesion and assessment of its extent.
2. CT Scan
Used to assess:
Sinus involvement
Bone changes
Surgical planning
3. MRI Scan
MRI is particularly helpful in:
Differentiating inverted papilloma from polyps
Identifying tumour attachment sites
4. Biopsy
A tissue sample confirms the diagnosis and excludes malignancy.
Accurate diagnosis is essential before any definitive treatment.
🛠️ How Is Inverted Papilloma Treated?
Surgery Is the Main Treatment
Inverted papillomas do not respond to medication.
Complete surgical removal is required to minimise recurrence and address cancer risk.
At Hampshire ENT Clinics and The Harbour Suite at QA Hospital, surgery is typically performed using:
Endoscopic sinus surgery
Removal of the tumour at its site of origin
Image-guided navigation in complex cases
Modern endoscopic techniques have largely replaced open surgery, offering:
Better visualisation
Lower recurrence rates
Faster recovery
No external scars
🔁 Why Long-Term Follow-Up Is Essential
Even after successful surgery, inverted papillomas can recur — sometimes years later.
For this reason, patients require:
Regular endoscopic follow-up
Periodic imaging when indicated
Long-term surveillance
This careful follow-up is a key part of safe management.
⚠️ Is Inverted Papilloma Cancer?
Most inverted papillomas are benign.
However:
Around 5–15% are associated with squamous cell carcinoma
Cancer may be present at diagnosis or develop later
This risk is why prompt diagnosis, complete excision and follow-up are essential.
🌟 Why Choose Hampshire ENT Clinics
Patients with complex nasal and sinus disease choose our service because we offer:
Consultant-led rhinology expertise
Experience managing rare nasal tumours
Advanced endoscopic and image-guided sinus surgery
Multidisciplinary links with radiology and cancer teams
Modern facilities
Convenient and rapid access
Care for patients across Portsmouth, Southampton, Winchester and Salisbury
Our priority is safe, complete treatment with careful long-term monitoring.
👉 If you’ve been diagnosed with an inverted papilloma or have persistent one-sided nasal symptoms, contact Hampshire ENT Clinics or Medicana Winchester for specialist assessment.
Frequently Asked Questions (FAQs): Inverted Papilloma
What is an inverted papilloma?
An inverted papilloma is a benign but locally aggressive tumour arising from the lining of the nose and sinuses (Schneiderian mucosa). Although non-cancerous, it behaves differently from nasal polyps and requires specialist care.
How is an inverted papilloma different from nasal polyps?
Unlike inflammatory nasal polyps, inverted papillomas:
Grow inward into underlying tissue
Can erode surrounding bone
Have a high recurrence rate if not completely removed
Carry a small but significant risk of associated cancer
For these reasons, they are managed very differently.
What symptoms suggest an inverted papilloma?
Typical symptoms include:
Persistent one-sided nasal blockage
Unilateral nasal discharge (sometimes blood-stained)
Reduced sense of smell
Recurrent sinus infections on one side
Facial pressure or pain
Nosebleeds
Unilateral symptoms are an important red flag in ENT practice.
How is inverted papilloma diagnosed?
Diagnosis usually involves:
Nasal endoscopy to visualise the lesion
CT scanning to assess sinus involvement and bone changes
MRI scanning to differentiate inverted papilloma from polyps and identify tumour attachment
Biopsy to confirm the diagnosis and exclude malignancy
Accurate diagnosis is essential before treatment.
Can inverted papilloma be treated with medication?
No. Inverted papillomas do not respond to medical treatment such as sprays or antibiotics. Surgery is required.
What is the treatment for inverted papilloma?
The mainstay of treatment is complete surgical removal, usually performed using advanced endoscopic sinus surgery. The goal is to remove the tumour fully at its site of origin to minimise recurrence.
Is open surgery ever required?
In most cases, modern endoscopic techniques are sufficient and have replaced open surgery. Open approaches are now rarely needed and are reserved for very extensive disease.
What are the benefits of endoscopic surgery?
Endoscopic surgery offers:
Excellent visualisation of the tumour
Lower recurrence rates
No external scars
Faster recovery
The ability to use image-guided navigation in complex cases
Is inverted papilloma cancerous?
Most inverted papillomas are benign. However:
Around 5–15% are associated with squamous cell carcinoma
Cancer may be present at diagnosis or develop later
This is why complete removal and long-term follow-up are essential.
Can inverted papilloma come back after surgery?
Yes. Recurrence can occur, sometimes years later, even after successful surgery. Long-term surveillance is a critical part of care.
What follow-up is required?
Patients usually need:
Regular endoscopic nasal examinations
Periodic imaging where indicated
Long-term follow-up, often for several years
Where can I be assessed and treated?
Assessment and treatment are available at Hampshire ENT Clinics and Medicana Winchester, with specialist rhinology care for patients from Portsmouth, Southampton, Winchester, Salisbury, and across Hampshire.
When should I seek urgent ENT advice?
You should seek prompt assessment if you have:
Persistent one-sided nasal blockage
Recurrent unilateral sinus infections
Blood-stained nasal discharge
Facial pain or pressure on one side