Isolated inverted papilloma of the sphenoid sinus.

Primary inverted papilloma of the sphenoid sinus is rare. Such a case, of a 42-year-old female, is reported here, discussing the clinical presentation, diagnostic clues, radiographic features, histological findings and management. In contrast to the vast majority of cases that present with nasal complaints because of lateral nasal wall involvement, the clinical presentation of inverted papillomas confined to the sphenoid sinus is often nonspecific and insidious. Nasal endoscopy and radiologic imaging are key to an accurate diagnosis. Preoperative imaging with computed tomography and the surgeon's experience will dictate the appropriate surgical approach. In our opinion, transnasal endoscopic large sphenoidotomy remains an effective modality for management of patients with this lesion when the sphenoid sinus is the only sinus requiring investigation. A more anatomically directed approach to the sphenoid sinus with less violation of other sinuses can be achieved.