title: Long-term results of endonasal sinus surgery in sinonasal papillomas.
abstract: OBJECTIVE
  To assess the value of endonasal sinus surgery in the management of sinonasal papillomas.
  
  
  METHODS
  Retrospective study including 43 patients operated on for sinonasal papilloma in a long-term follow-up.
  
  
  METHODS
  In 26 cases (60%) an endonasal approach, in eight cases (19%) an external approach, and in four cases (9%) a combined procedure was performed to remove these tumors. Five septal lesions (12%) were resected under direct vision. The original sections and charts of all patients were reviewed to assess clinical data. Follow-up information was available for 42 of our patients (98%) with a mean follow-up of 62 months.
  
  
  RESULTS
  Histologic examination revealed 34 cases of inverted papilloma (79%), five cases of exophytic papilloma (12%), and four cases of columnar cell papilloma (9%). Malignancy occurred in 4 of 43 patients (9%), and recurrences developed in 8 of 42 patients (19%). Two of these recurrences happened after endoscopic sinus surgery (two inverted papillomas), three after lateral rhinotomy (three inverted papillomas), one after a combined procedure (one inverted papilloma), and two after simple resection (two exophytic papilloma).
  
  
  CONCLUSIONS
  In keeping with our experience, the endonasal endoscopic approach, often in combination with a medial maxillectomy, is favored for the treatment of sinonasal papilloma because of a lower recurrence rate and a better cosmetic result. In some larger tumors and lesions in difficult locations, better visualization can be obtained by a combined external and endonasal approach.
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, University Hospital of Lausanne, Switzerland.
authors.forename: Marcel
authors.initials: M
authors.lastname: Kraft
authors.forename: Daniel
authors.initials: D
authors.lastname: Simmen
authors.forename: Thomas
authors.initials: T
authors.lastname: Kaufmann
authors.forename: David
authors.initials: D
authors.lastname: Holzmann
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004724:Endoscopy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008866:Microsurgery; D008875:Middle Aged; D009300:Nasal Septum / Q000473:pathology / Q000601:surgery; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis / Q000473:pathology / Q000601:surgery; D009666:Nose / Q000473:pathology / Q000601:surgery; D009669:Nose Neoplasms / Q000145:classification / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*; D010212:Papilloma / Q000145:classification / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*; D010255:Paranasal Sinus Neoplasms / Q000145:classification / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*; D010256:Paranasal Sinuses / Q000473:pathology / Q000601:surgery; D012086:Reoperation; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome