الفهرس 
Human Papilloma virusOnly 14 pages are availabe for public view
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Abstract
Inverted papilloma (IP) is a benign tumor of the sinonasal area, known for local aggressiveness, associated malignancy, high rate of recurrence. Accordingly wide local surgical excision is mandatory.
The inverted papilloma is a benign epithelial tumor of the nasal mucosa and paranasal sinuses. It originates mostly from the lateral nasal wall or within the maxillary sinus. It affects three males for every female, mostly in the fifth and sixth decades of life.
Its exact etiology is still uncertain. Studies using in situ hybridization and PCR have detected HPV in up to 86% of IPs, Other various factors such as smoking, exposure to certain chemicals, allergy and chronic inflammation have also been implicated but has not been proved yet.
Mostly HPV 6, 11, 16 and 18 have been found to be correlated with IP. The presence of HPV DNA in IP have been found to be associated with higher chance of recurrence and malignant transformation.
Sinonasal papillomas are classified according to their pattern of growth. First, inverted papilloma (IP) and, second, fungiform papilloma . The third group were known as cylindrical cell papilloma.
The commonest symptom of sinonasal IP is a progressive unilateral nasal obstruction. Other symptoms include blood mixed nasal discharge, headache, facial pain, frequent clearing of throat, decreased or loss of smell, epiphora or symptoms suggestive of sinusitis.
The methods of HPV detection includes HPV polymerase chain reaction testing (PCR), HPV in situ hybridization analysis (ISH),
SUMMARY
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immunohistochemical staining for P16 protein (Tumor suppressor protein), E6/E7 mRNA method.
The advent and development of nasal endoscopic surgery, has made it possible to locate the tumor and its insertion more precisely. Consequently, it is now possible to remove this tumor completely by an endonasal endoscopic approach, with comparable recurrence rates to aggressive external procedures such as lateral rhinotomy and medial maxillectomy.
In our study, 28.5% (6/21) of cases were positive by PCR for HPV subtypes 6,11and, 18, which means nearly the same results as the published reports.
Etiology of IP is still unclear and, need more researches with more investigations and, more number of cases with another methods for detection which may be more accurate such as E6, E7 mRNA .