title: Inverted papilloma: new classification and guidelines for endoscopic surgery.
abstract: BACKGROUND
  Surgery is the gold standard in the management of inverted papilloma (IP); however, the approach and extent of the surgical procedure are still controversial. Moreover, there is still no universal staging system of IP to plan surgery and/or evaluate results. We performed a retrospective study.
  
  
  METHODS
  A new classification depending on the origin of the lesion was used to plan surgery in 70 cases of IP. Conservative transnasal endoscopic excision was performed in lesions arising from the nasal septum and lateral nasal wall (type I IP, 42 cases) and radical transnasal endoscopic medial maxillectomy was performed in lesions arising from the maxillary sinus (type 1 IF, 28 cases).
  
  
  RESULTS
  Excluding cases with a follow-up of <2 years, follow-up for periods ranging between 2 and 13.3 years with a median of 78 months showed recurrence in a single case of type I (3.2%) and 2 cases of type II (9.5%).
  
  
  CONCLUSIONS
  The new classification system, based on the origin of IP, is a simple tool for grading IP. It can be used to define cases suitable for conservative excision or radical medial maxillectomy. Both could be performed transnasally and endoscopically.
authors.affiliation: Department of Rhinology, Cairo University, Cairo, Egypt.
authors.forename: Reda
authors.initials: R
authors.lastname: Kamel
authors.forename: Ashraf
authors.initials: A
authors.lastname: Khaled
authors.forename: Tarek
authors.initials: T
authors.lastname: Kandil
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009296:Nasal Cavity / Q000473:pathology / Q000601:surgery*; D009367:Neoplasm Staging / Q000379:methods*; D009669:Nose Neoplasms / Q000145:classification* / Q000473:pathology / Q000601:surgery*; D018308:Papilloma, Inverted / Q000145:classification* / Q000473:pathology / Q000601:surgery*; D012189:Retrospective Studies; D018570:Risk Assessment