title: Inverted papilloma: feasibility of endonasal surgery and long-term results of 87 cases.
abstract: BACKGROUND
  The aim of this retrospective study was to assess the potentials and limitations of endonasal micro-endoscopic sinus surgery in the management of sinonasal inverted papilloma (IP) and to demonstrate long-term results.
  
  
  METHODS
  Eighty-seven patients underwent resection of an IP either via an endonasal, an osteoplastic maxillary or frontal sinus or a combined approach. Charts were reviewed for presenting symptoms, tumour stage according to the Krouse classification, surgical management and follow-up status.
  
  
  RESULTS
  Most tumours were staged as T2 or T3 (42.5% each). Sixty-eight (78.2%) patients were referred for primary surgery. Nineteen (21.8%) patients presented with recurrent disease. The majority of IP (70%) were removed via an endonasal micro-endoscopic procedure. In 20 (23%) patients a combined approach was performed. The overall recurrence rate was 10.3%. Referring to endonasal surgery the incidence of recurrent IP was 10% in contrast to 15% after a combined procedure.
  
  
  CONCLUSIONS
  Our data show that endonasal micro-endoscopic surgery offers an effective and safe treatment modality of IP with insignificant morbidity. Strict application of selection criteria, wide removal of the tumour origin along the subperiosteal plane as well as drilling the underlying bone and close follow-up of patients are mandatory for success.
authors.affiliation: Department of Otorhinolaryngology, Head and Neck and Facial Plastic Surgery, Klinikum Fulda gAG, Teaching Hospital of the Philipps-University Marburg, Fulda, Germany.
authors.forename: Amir
authors.initials: A
authors.lastname: Minovi
authors.forename: Malte
authors.initials: M
authors.lastname: Kollert
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Draf
authors.forename: Ulrike
authors.initials: U
authors.lastname: Bockmühl
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004724:Endoscopy / Q000379:methods*; D005240:Feasibility Studies; D005500:Follow-Up Studies; D006801:Humans; D008866:Microsurgery; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009669:Nose Neoplasms / Q000473:pathology / Q000601:surgery*; D018308:Papilloma, Inverted / Q000473:pathology / Q000601:surgery*; D012189:Retrospective Studies; D016896:Treatment Outcome