Aggressive endoscopic resection of inverted papilloma: an update.
OBJECTIVE
Endoscopic resection has been proposed for sinonasal inverted papilloma (IP). Our objective was to determine the efficacy of aggressive endoscopic resection of IP.


METHODS
Retrospective analysis was performed on patients undergoing endoscopic resection of IP at the University of Virginia between 1990 and 1996. Total ethmoidectomies, wide maxillary antrostomies, frontal recess explorations, sphenoidotomies, and turbinate resection were performed as required. Once all visible papilloma was removed, residual mucosa was removed by using a diamond burr to polish bone at the site of origin.


RESULTS
Twenty-one patients were treated with endoscopic resection of IP. Only 1 of 21 patients had an adjunctive external procedure (an osteoplastic flap without obliteration). Average follow-up was 41.9 months after initial aggressive endoscopic resection at the ureterovesical angle. Recurrences occurred in 19% (4/21) of patients. One of the 4 had two recurrences. Recurrences occurred in 16 months or less, except for one noted at 35 months and another at 56 months.


CONCLUSIONS
Aggressive endoscopic resection of IP by experienced rhinologists is an acceptable treatment.
Schlosser
R J
RJ
Department of Otolaryngology-Head and Neck Surgery, University of Virginia, Charlottesville, USA.
Mason
J C
JC
Gross
C W
CW
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D004724:Endoscopy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009297:Nasal Mucosa / Q000473:pathology; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology* / Q000473:pathology; D009669:Nose Neoplasms / Q000175:diagnosis / Q000601:surgery*; D018308:Papilloma, Inverted / Q000175:diagnosis / Q000601:surgery*; D010256:Paranasal Sinuses / Q000473:pathology / Q000601:surgery*; D012189:Retrospective Studies; D018570:Risk Assessment; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome