title: Minimally invasive treatment of the nasal inverted papilloma.
abstract: BACKGROUND
  The purpose of this work is to evaluate our results in the treatment of the nasal inverted papillomas with an endoscopic approach using a retrospective case series.
  
  
  METHODS
  Between 1993 and 2000 we treated 27 patients with nasal inverted papillomas. All patients underwent endoscopic nasal surgery under general anesthesia. None of the inverted papillomas extended outside of the paranasal sinuses. All tissue samples underwent polymerase chain reaction and hybridization in situ to detect genetic sequences of the human papilloma virus and Epstein Barr virus.
  
  
  RESULTS
  The study population consisted of 16 men and 11 women with a median age of 52 years (range, 22-77 years). Ten patients (37%) had undergone a previous nasal surgery. The median follow-up was 5 years (range, 2-8 years). None of the patients presented with bilateral nasal involvement or a synchronous carcinoma. Seven patients underwent an additional surgical approach (two endoscopic approaches via a Caldwel-Luc approach, four sublabial approaches via a Caldwel-Luc approach, and one external ethmoidectomy). There were no surgical complications. Two patients (7%) had recurrent papilloma 4 and 6 years after surgery and again underwent endoscopic resection. The amplification both by polymerase chain reaction and hybridization in situ for human papilloma virus and Epstein Barr virus were negative in the specimens from all patients.
  
  
  CONCLUSIONS
  According to the literature and our own experience, we believe that the initial surgical management of primary and recurrent inverted papillomas limited to the nasal cavity and paranasal sinuses should be endoscopic sinus surgery.
authors.affiliation: Department of the Ear, Nose, and Throat, Hospital Central Universitario de Asturias, Oviedo, Asturias, Spain.
authors.forename: José L
authors.initials: JL
authors.lastname: Llorente
authors.forename: Fred
authors.initials: F
authors.lastname: Deleyiannis
authors.forename: Juan P
authors.initials: JP
authors.lastname: Rodrigo
authors.forename: Faustino
authors.initials: F
authors.lastname: Nuñez
authors.forename: Pilar
authors.initials: P
authors.lastname: Ablanedo
authors.forename: Santiago
authors.initials: S
authors.lastname: Melón
authors.forename: Carlos
authors.initials: C
authors.lastname: Suárez
mesh_terms: D000328:Adult; D000368:Aged; D004724:Endoscopy; D005260:Female; D004854:Herpesvirus 4, Human / Q000302:isolation & purification; D006801:Humans; D017403:In Situ Hybridization; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D009669:Nose Neoplasms / Q000000981:diagnostic imaging / Q000382:microbiology / Q000601:surgery*; D018308:Papilloma, Inverted / Q000000981:diagnostic imaging / Q000382:microbiology / Q000601:surgery*; D027383:Papillomaviridae / Q000302:isolation & purification; D016133:Polymerase Chain Reaction; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed