Nasal papillomas: causes and treatment methods

Symptoms of papillomas of the nasal cavity and nasopharynx

If papillomas are located inside the nasal passages, the disease may manifest itself with the following symptoms:

Stuffy nose

Papillomas can grow, and at some point a person begins to feel nasal congestion.

More about the symptom

Postnasal drip syndrome

Papillomas can cause postnasal drip syndrome. The nasal cavities contain glands that produce mucus. If a person does not have a runny nose, little mucus is produced. It serves to moisturize the nasal passages and binds dust and bacteria that have entered there. Sometimes a person sneezes or blows his nose, thereby removing mucus from the nose. Papillomas can reach significant sizes, blocking the mucus path. In this case, mucus begins to accumulate and then flow down the nasopharynx (this is postnasal drip syndrome). As a rule, an accumulation of mucus in the throat is felt in the morning, after a night's sleep.

Nosebleeds

When mechanically damaged, papillomas can cause nosebleeds.

Diagnostics

Due to similar symptoms, papilloma of the nasal vestibule must be distinguished from basal cell carcinoma (a type of skin cancer) and squamous cell carcinoma in the initial stage.

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Also, papillomas of the nasal cavity, if the disease constantly recurs, must be distinguished from the initial forms of cancer of the nasal cavity.

Treatment methods for papillomas of the nasal cavity and nasopharynx

It is advisable to remove papillomas found in the nasal cavity and nasopharynx. Papillomas that have caused at least some concern must be removed.

Removal of papillomas

Removal of papillomas is best done using modern high-tech methods. This is radio wave removal or laser removal. This removal is easily tolerated by the patient. The technology ensures rapid healing, the risk of re-formation of papilloma is minimal.

Removal of papillomas of the nasal cavity with a laser or radio wave scalpel with Surgitr is carried out at JSC “Family Doctor”.

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Epithelial tumors

Papillomas. There are papillomas of the vestibule and the nasal cavity. The first ones are gray in color, dense, villous surface, small in size, not malignant. It is believed that papillomas are caused by viruses from the family of papillomoviruses types 6, 11 and 16. Papillomas of the nasal cavity primarily affect the mucous membrane. They often recur after surgical removal. With anterior rhinoscopy or endoscopy, papillomas are gray-white in color, soft in consistency, single or multiple, bleed when touched, and resemble cauliflower. Treatment of nasal papillomas is predominantly surgical or cryodestruction. Surgically removed material should be sent for histological examination due to the possibility of malignant degeneration (transitional cell carcinoma). Another problem in the treatment of these patients is the frequent recurrence of papillomas. To prevent it, it is recommended to prescribe interferon drugs - domestic Laferon or foreign intron A. The method of treatment with Laferon consists of inhalation administration at the beginning of therapy (1 million Laferon is diluted in 20 ml of 0.9% NaCl solution). Inhalations continue for the first 10 days, then Laferon is prescribed intramuscularly once a day, at a dose of 1 million units, for 20 days. Some clinics determine the titers of antibodies to it to monitor the presence of the virus in the blood serum. When the levels increase above 1:200 in the blood of patients, antiviral drugs (Zoverax or others) are prescribed. Papilloma viruses also infect the cervix, which leads, in less pathogenic types, to the occurrence of condylomas.

Inverted papilloma. Called due to the ability of squamous epithelium to invaginate in the form of a wide ribbon into the connective tissue, these tumors have destructive growth, recur and become malignant. They are also known as columnar cell papillomas.

Adenoma is a benign tumor of the glandular epithelium of the nasal mucosa. It mainly affects the lower parts of the nasal cavity on a broad base with a smooth surface. Characterized by slow growth. The tumor is erysipelas-gray in color, no more than 2 cm in size, and is accompanied by rapid growth, germination into adjacent tissues, and changes in the histological structure. Its treatment is surgical. The removed material should be examined histologically.

Nonepithelial tumors

Hemangioma is a tumor developing from blood vessels, similar in nature to developmental defects. What it has in common with other tumors is rapid growth, during which hemangioma destroys surrounding tissue and causes a cosmetic and sometimes functional defect. In 1863, Vikhrov published a macro-microscopic classification of hemangiomas, dividing them into capillary, cavernous and racemose (branched). Subsequently, this principle was included in many classifications.

Today, this classification is used, which includes additional data on tumor growth, its spread, blood supply characteristics and relationship with large blood vessels.

True hemangiomas: 1) capillary (simple): exophytic (venous and arterial type); 2) cavernous: mucous-submucosal; diffuse (spreading into depth); 3) branched (angiodysplasia); 4) mixed (angiofibromas, hemlymphangiomas, branched with cavernous, branched with Barre-Mason glomusangiomas, etc.).

Diagnosis of tumors in the nose

1. Routine external examination of the patient. Palpation of the tumor.
2. Anterior and posterior rhinoscopy.
3. Examination of the nasal cavity and paranasal sinuses using an endoscope. Diaphanoscopy.
4. Comprehensive X-ray examination.
5. CT and MRI.
6. Cytological examination of discharge obtained during puncture, sinus lavage, as well as nasal discharge.
7. Histological examination of pieces of the neoplasm.

Treatment of nasal tumors

1. Surgical removal of the tumor (if it is of significant size with preliminary embolization of the vessels feeding the tumor).
2. Cryodestruction of the tumor.
3. Sclerosis therapy.
4. Radiation therapy in combination with surgical removal (for tumor malignancy).

Bleeding polyps of the cartilaginous part of the nasal septum are red, round in shape with a smooth surface. They are characterized by frequent bleeding. Treatment is surgical.

Fibromas, myomas, lipomas are rarely found in the cavity and paranasal sinuses. Angiofibroma, fibromyoma, osteofibroma, adenofibroma, neurofibroma, histiocytoma may occur. The treatment of these tumors is surgical.

Osteomas. They are most common among benign tumors of the paranasal sinuses, in people 20-40 years old. According to some authors, osteomas are localized in the area of ​​bone sutures in 50% of patients. Histologically, three forms of osteomas are distinguished: compact (ivory), spongy and compact-spongy. Osteomas are extremely slow growing and predominantly asymptomatic. They are often discovered incidentally during X-ray or CT scanning. With large tumors or localization in the main sinus, a headache may be observed; with osteomas of the frontal sinus, exophthalmos, diplopia, and visual impairment may be observed.

Treatment of osteomas is exclusively surgical. The sooner it is carried out, the better success will be achieved. Mandatory histological examination of the removed tumor. Sometimes, with compact osteomas of the main sinus, when there is a risk of serious complications (damage to the cavernous sinus, internal carotid artery), surgical intervention should be carried out jointly with neurosurgeons.

Chondromas. They develop from the remains of the primordial cartilaginous skeleton and can be attributed to developmental anomalies. Tumors are characterized by slow expansive growth with penetration into the orbit or cranial cavity. They often recur and, in addition, can become malignant. Osteochondromas can occur in the nasal cavity. Neurogenic tumors

Paragangliomas (glomus tumors, chemodectomas) grow from small cell groups of the nasal mucosa. Rarely found in the nasal cavity. The tumor has infiltrative growth, often recurs, and malignantly degenerates. In such cases, it often grows into the skull and brain.

Tumor-like lesions

Tumor-like diseases are described in the relevant sections of the reference book, but fibrous dysplasia deserves special attention.

Fibrous dysplasia. Refers to tumor-like lesions of the nose and paranasal sinuses and is a defect in the formation of osteogenic mesenchyme. Characterized by the replacement of bone with fibrous tissue. Some authors consider the disease to be a developmental anomaly of unknown origin. Diagnosis of the disease is radiological but mainly histological confirmation is the main motive for choosing treatment. This lesion is also known as fibrous osteodystrophy, osteitis fibrosa. The bones of the upper jaw, main and frontal bones are predominantly degenerated. Treatment is surgical. The affected bone areas are removed. Relapses are possible. Sometimes such patients are treated in dental hospitals. V.

Malignant tumors of the nose and paranasal sinuses

The incidence of malignant tumors is steadily increasing by 2.6-3.0% per year. Malignant tumors of the nose and paranasal sinuses account for about 0.5% of cancer incidence statistics. In 2002, per 100 thousand population of Ukraine, the incidence of malignant tumors of this localization was 0.59, 287 patients were diagnosed for the first time. For comparison, in Belarus in the same year it was 0.7, 70 patients were identified. In Russia, 832 patients were detected for the first time, the incidence was 0.6. In the United States, 2,000 patients with cancer of the nasal cavity and paranasal sinuses are diagnosed annually.

Localization of tumors in the nose and paranasal sinuses, which are a system of narrow thin-walled cavities rich in nerves, blood and lymphatic vessels, promotes growth and rapid spread to adjacent formations, which significantly complicates treatment and leads in many cases to death.

Among the factors that cause malignant growth in this area are wood dust, petroleum products, professions associated with exposure to potent compounds - benzenes, acids, alkalis, nickel ores, varnishes and smoking. Among the factors that contribute to the growth of these tumors, chronic diseases are also noted - rhinitis, polypous sinusitis, ethmoiditis, frontal sinusitis, viral agents. The Epstein-Bar virus is considered the etiological factor of malignant lymphomas, papillomovirus types 11, 16, leads to the occurrence of transitional cell carcinoma and papillomas in the area of ​​the nasal epithelium.

In most cases, the disease affects people of working age. Early clinical manifestations in people with tumors of this localization are insignificant and therefore the disease is more often detected in stages III – IV, when the walls of the cavities are already destroyed and penetration into adjacent anatomical areas begins.

According to most authors, malignant tumors are most often localized in the maxillary sinus (75-80%), in second place are the cells of the ethmoidal labyrinth and the nasal cavity (10-15%), less often the sphenoid and frontal sinuses are affected (1-2%).

When treating people with malignant tumors of the nose and paranasal sinuses, surgical, radiation and chemotherapy methods are used, but the results remain unsatisfactory, while the number of patients with this pathology does not decrease.

It should be noted that the palette of morphological forms of malignant tumors of the nose and paranasal sinuses is diverse.

Basal cell carcinoma occurs more often in various areas of the skin of the nose. Trichoepithelioma also belongs to basal cell malignant neoplasms.

Melanoma is observed in 2-3% of malignant tumors of this location. Most often it is located in the nasal cavity. The tumor is characterized by polymorphism. However, the sarcomatous form predominates. Early symptoms include bleeding and difficulty breathing. Melanoma metastasizes in 60% of cases to the cervical lymph nodes.

Clinical picture of tumors in the nose

Clinical manifestations of malignant tumors depend on the stage of the disease, localization, growth form, as well as the morphological structure of the tumor.

Symptoms:

1. Pain. They appear sharply when localized in the upper jaw along the n. trigeminus. When the tumor is localized or grows into the area of ​​the pterygopalatine fossa, shooting pain appears in the area of ​​the eyeball or temple, which indicates irritation of the n.auriculotemporalis. Pain as the first sign of the disease was observed in 17% of patients.
2. Impaired nasal breathing. When the tumor was localized in the nose, similar complaints were noted in 62.8% of patients. Patients whose tumor did not spread beyond the paranasal sinuses, or those whose tumor grew towards the cheek, temporal bone, alveolar process, or orbit did not complain of nasal breathing disorder.
3. Nasal discharge. More often they are unilateral mucopurulent with an admixture of blood.
4. Headache of various types, often with various paresthesias in the facial area on the side of the tumor. Often in such cases neuralgia is diagnosed. If they are not treatable, you should always remember about the possible development of a malignant disease.
5. Pain in the teeth, deformation of the face, nose, lacrimation, exophthalmos, deformation of the hard and soft palate - these symptoms can occur to varying degrees with malignant tumors of the nose and paranasal sinuses.

Malignant tumors of the mucous membrane of the maxillary sinus occur without symptoms for a long time. Clinical manifestations depend on the starting point and size of the tumor. Tumors arise on all walls of the sinus, from the superomedial part of the sinus they quickly cause bleeding, swelling of the eyelids, lacrimation, exophthalmos; when they grow forward, they grow into the anterior wall and then in the cheek area they can be identified by palpation. As the tumor grows downward, it grows into the hard palate and changes its configuration. The growth of a tumor from the medial wall into the nasal cavity makes breathing difficult and leads to the formation of polyps. If the tumor grows predominantly in the direction of the posterior wall with germination into the fossa, the nasal part of the pharynx, then it causes pain.

When a tumor destroys the orbital wall, the process spreads to the orbital tissue, which is manifested by exophthalmos, decreased visual acuity and diplopia. Malignant tumors of the ethmoid labyrinth. Isolated lesions of the labyrinth cells are observed in 10% of cases.

When the tumor spreads towards the orbit, the thin wall of the latter is destroyed and tumor growth into the orbit is observed.

From the cells of the labyrinth, neoplasms can also spread to the maxillary, sphenoid sinuses, anterior and middle cranial fossa, and nasal pharynx.

Tumors of the sphenoid (main) sinus. Primary cancer of this location is extremely rare. Typically, these are tumors that extend from the maxillary sinus or ethmoid. The earliest symptoms are ocular, often damage to the efferent nerve, less often - decreased vision. Patients seek help from an ophthalmologist or neurologist. Characteristic orbital-superior syndrome (damage to the vessels and nerves that pass through the optic foramen and the superior orbital fissure), visual impairment, up to blindness, ptosis, diplopia, pain in the occipitotemporal and occipital regions.

Tumors of the frontal sinus are rare and have symptoms when affected, which do not extend beyond the sinus, similar to the symptoms of chronic frontal sinusitis. In recent years, CT and MRI have made it possible to differentiate this disease from mucocele, osteomyelitis and sinusitis. Symptoms depend on the direction of tumor growth. Germination downwards and medially leads to penetration into the orbit, ethmoidal labyrinth, exophthalmos appears, germination posteriorly - the anterior cranial fossa is affected, then a sharp headache, convulsions, and mental disorders are possible. Penetration of the tumor through the anterior wall leads to swelling and discoloration of the skin in the frontal area of ​​the head.

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Treatment

The most effective drug for solving the problem in children and adults is Vifiron. It has an antiviral effect. The ointment has a mild effect on the surface of the skin without causing burns. In addition to local treatment of lesions, measures to strengthen the immune system are required.

Self-medication is dangerous with complications!

Attention

Despite the fact that our articles are based on trusted sources and have been tested by practicing doctors, the same symptoms can be signs of different diseases, and the disease may not proceed according to the textbook.

Pros of seeing a doctor:

• Only a specialist will prescribe suitable medications.

• Recovery will be easier and faster.

• The doctor will monitor the course of the disease and help avoid complications.

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Growths on the nose, like on other parts of the face, require emergency medical attention. Otherwise, warts are dangerous due to a number of complications associated with infection of neighboring tissues.

In the absence of therapeutic measures, benign papillomas often degenerate into cancerous tumors.

Methods for quickly combating the problem

Radical methods for removing warts on the nose include:

• laser survival;
• cryodestruction;
• electric currents;
• radio waves;
• traditional surgical removal using a scalpel.

Laser removal is one of the most common and effective methods in combating the problem. Wart removal occurs painlessly and in a short time. The only drawback of the procedure is its high cost. After laser wart survival, there are no scars left on the face.

Cryodestruction is a quick but painful way to remove a tumor on the nose. Sometimes after surgery the problem reappears and will require further intervention to eliminate it.

After eliminating the tumor, the patient feels discomfort in this area for 2-3 days. With careful and timely treatment of the wound after removing the papilloma, there will be no traces left on the nose.

Electrocoagulation is rarely used to treat facial warts. The technique gives a positive result only in the fight against small-sized tumors with shallow roots.

Causes of nasal papillomas

Warts on the nose are caused by the human papillomavirus. It attacks epithelial cells, causing them to divide randomly and form benign or malignant tumors.

The main way of acquiring HPV is through sexual intercourse. Viral particles are found in large quantities in all human biological fluids, so contact and household transmission cannot be ruled out when injured skin comes into contact with hygiene items or things on which traces of the virus remain. Children can become infected in utero and during childbirth from an infected mother.

Not all types of virus can cause cancer. The carcinogenicity of HPV types 16, 18, 51 and 52 has been confirmed. They are responsible for cervical and ovarian cancer. Other types of the virus cause only benign formations, such as papillomas of any location and genital warts.

Penetration of the virus into the blood does not necessarily guarantee the development of papillomas in the nose. In order for HPV to invade cells and disrupt their normal life cycle, the body’s defenses must be reduced. The following play an important role in weakening the immune system:

• unbalanced diet;
• bad habits;
• stress and overwork;
• elderly age;
• the presence of chronic diseases in the acute stage;
• immunodeficiency states;
• long-term use of antibiotics, hormonal therapy, cytostatics;
• hypothermia;
• poor environmental conditions in the area of ​​residence.

Nasal growths occur more often in people suffering from chronic ENT pathologies (sinusitis, allergic rhinitis) or who often suffer from colds.

Reasons for development

Papillomavirus enters the body in two ways:

• contact;
• airborne.

Most often, infection occurs through the first route. Airborne transmission of the virus is more common in medical institutions.

Doctors become infected when removing papilloma from the patient's body using electrocoagulation or laser radiation. These methods involve burning out the tumor, as a result of which particles of the latter containing the virus penetrate into the air.

Papillomas in the nose are more common in the practice of an otolaryngologist.
As a rule, doctors of this specialization remove papillomas. The radio wave method is used more often.

Dermatovenerologist, cosmetologist

Zhikhoreva Inna Viktorovna

6 years experience

HSV penetrates into the immature basal layer of the mucosa. It provokes active cell growth, which leads to the formation of papillomas.

These tumors contain a virus that easily spreads through the sinuses, causing the appearance of new warts.

People at risk for contracting human papillomavirus include:

• have promiscuous sexual intercourse;
• come into contact with carriers of the virus;
• visit public institutions such as baths and swimming pools;
• do not follow hygiene rules.

HSV is present in the human body almost throughout life. It is often inherited. In a healthy person, the immune system suppresses the activity of the virus. He becomes agitated due to the weakening of natural defenses.

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The virus is activated under the influence of the following factors:

• addiction to smoking and alcohol;
• infectious infection of the body;
• long-term use of medications ;
• exacerbation of chronic pathologies and others.

Nasal papillomas disappear without outside intervention within the first three years, provided that the immune system works without failures.

Causes

The main reason for the appearance of warts on the nose is the penetration of HPV into the patient’s body. The pathogen enters a person through microtraumas on the surface of the skin, as well as through the mucous membranes of the respiratory tract. The nasal area is especially vulnerable to the influence of external factors.

During ARVI, patients comb this area and rub it with a handkerchief, which contributes to skin injury. The infectious pathogen easily penetrates through lesions on the skin into deep tissues, becoming the cause of warts.

An abnormal growth on an organ can occur after touching it with dirty hands, someone else’s personal hygiene products, etc.

Removing warts with nitrogen

Cryodestruction is a method of removing warts by exposing them to liquid nitrogen.

After the incubation period, particles of the viral pathogen provoke active division of epidermal cells, thus creating a growth on the surface of the skin. Initially, it has a dense structure and rises slightly above the epidermis.

As the wart develops, it acquires convex shapes and grows in size. The shape of the formation can be thin, papillary or elongated. The type of wart depends on the type of viral pathogen that has entered the body.

A certain amount of time passes from the moment of infection to the appearance of the first symptoms. HPV can remain in the body throughout life, but without showing characteristic signs. This suggests that the immune system inhibits the development and reproduction of the pathogenic organism.

In some cases, the pathogen, on the contrary, progresses and manifests itself quickly. Provoking factors for the development of pathology include:

• increased activity of the sebaceous glands;
• insufficient care of the facial area;
• hormonal problems;
• disruption of metabolic processes in the body;
• period of bearing a child;
• a decrease in the body's defenses for various reasons.

A child can become infected with HPV in utero from the mother. And in this case, the outgrowths will be located on the membranes of the lips, nose and eyes. Sometimes warts go away on their own, after avoiding contact with the irritating factor. The recovery period lasts from 6 months or more. More often, skin growths are dealt with through surgery or medications.

Varieties

Based on their structure, there are two main types of nasal papillomas (photo):

• squamous - an aggressive form that has rapid growth and a high tendency to malignancy. Most often found on the side wall of the nose, it grows into soft tissue and can affect bones;
• inverted - grows on the side walls of the nasal cavity and paranasal sinuses; with intensive growth, it blocks the lumen of the nostril, making breathing difficult. Transition to a cancerous tumor is much less common than in squamous cell tumors.

Depending on the location of the papilloma there are:

• under your nose . Appear when the area is frequently traumatized during shaving or with a prolonged runny nose;
• on the tip of the nose . A cosmetic defect in the form of a rounded growth, rarely makes it difficult to breathe and causes injury, but more often causes psychological discomfort;
• in the partition . Favorite localization of genital warts, which have a tendency to develop into a malignant tumor. Often damaged when cleaning the nose, they bleed heavily and become inflamed;
• in anticipation of . Occurs after prolonged respiratory infections accompanied by a severe runny nose;
• in the paranasal sinuses. Overgrowth of papillomas of various shapes in the sinuses of the nose due to chronic inflammatory processes. They can completely block the lumen of the sinus, disrupting normal communication with the nasal cavity and causing exacerbations of chronic sinusitis and sinusitis.

Prevention

Infection with the papillomatosis virus and the formation of papillomas in the nose is easier to prevent than to select effective treatment methods.

• The most effective method of preventing HPV is antiviral vaccination. Gardasil and Cervarix vaccinations protect against infection with the most dangerous carcinogenic types of HPV. They are recommended for girls over 8 years of age and women who have laboratory confirmed absence of HPV;
• protected sex. Using a condom for any type of sex reduces the risk of contracting the virus, but cannot completely eliminate it. With each new sexual partner, the likelihood of becoming infected with the human papillomavirus increases;
• healthy lifestyle. Physical activity, giving up bad habits, and proper nutrition promote health and help the immune system prevent infection with the virus.

Detection of papilloma in the nose is a reason for a mandatory visit to an ENT doctor. This is not just a cosmetic defect that causes inconvenience, but also a potential cancerous tumor. To prevent the growth from becoming malignant, it must be carefully examined and removed.

Red, brown, white papilloma. What color does it say?

Papilloma is a benign tumor, the appearance of which is caused by damage to the human papilloma virus. Infection can occur through unprotected sexual intercourse and through direct contact with a virus carrier. For many people, the virus is inactive, so they are not even aware of its existence.

Reader's recommendation. Our readers actively use this therapy to treat papilloma. More information

The color and shape of the growths may vary, but they are not dangerous until they begin to change. Their increase, change in color and shape may mean that the tumor has degenerated into a malignant tumor. In this case, treatment should be started immediately.

Red papilloma: causes and appearance

Sometimes a red papilloma initially appears on the body. This is due to the many design features of the building. This phenomenon should not be shocking. Red papillomas often appear on the skin of babies. They occurred due to the fact that the mother had an infectious disease during pregnancy.

In the same situation, if the original pink or fleshy growth suddenly turns red, this phenomenon cannot be ignored.

There are many factors that can cause this process:

• It grows and hurts;
• The patient is taking medications containing hormones;
• Alkaline products are used to remove sediment;
• Under pressure.

If the papilloma suddenly turns red and causes unpleasant pain, there is a high probability of injury. This led to bacterial infections in addition to viral infections.

How is the papillomas removal procedure performed?

Laser is most often used to remove papillomas; it is excellent for work if you need to remove many small papillomas. If you need to remove papillomas larger than 5 mm, we recommend the radio wave method. The methods are absolutely safe, do not injure deep skin tissues and leave no cosmetic defects such as scars. Laser and radio wave methods also have some advantages compared to other methods:

• There is no bleeding because the vessels are instantly cauterized;
• Thanks to coagulation of the bed where the papilloma was located, the risk of infection is reduced;
• Fast healing and short rehabilitation period;
• The risk of recurrence of papilloma is close to zero.

Taking into account the test results and visual examination, an experienced specialist will individually select an effective and safe method for removing papillomas.

Prices for removal of papillomas on the face

How many procedures do you need to undergo to remove papillomas on the face?

Removal of papillomas on the face occurs in just one procedure, however, in case of multiple formations, a repeat visit may be necessary. During the procedure, up to 20-30 papillomas can be removed, and in some cases more.

In the postoperative period, caring for the bed of a removed papilloma is not much different from the same manipulation with moles.