title: Recurrence of sinonasal inverted papilloma following surgical approach: A meta-analysis.
abstract: Inverted papilloma (IP) is a rare benign tumor, which is found in the sinonasal area. It is characterized by recurrence, local destruction, and malignant change. Of these, recurrence is a challenging problem to many otolaryngologists. In this study, we evaluated recurrence based on the type of surgical approach using a meta-analysis.
  
  
  
  MEDLINE, Embase, and Cochrane database.
  
  
  
  Relevant studies were identified by searching the following databases: MEDLINE, Embase, and Cochrane through February 2016. Random-effects models were used to estimate risk ratio (RR) and 95% confidence interval (CI). The Newcastle-Ottawa scale was used to assess the quality of cohort studies.
  
  
  
  Our search yielded 14 retrospective cohort studies involving a total of 696 endoscopic approaches and 444 nonendoscopic approaches. The pooled RR for IP recurrence (endoscopic vs. external approach) was 0.56 [95% CI: 0.36-0.85, I2=48.3%]. A subgroup analysis was also performed.
  
  
  
  Surgical management of IP via an endoscopic approach reduces the risk of recurrence compared to an external approach. Although further data are needed, early- stage IP requires endoscopic or endoscopic-assisted surgery to reduce the risk of tumor recurrence.
  
  
  
  NA Laryngoscope, 127:52-58, 2017.
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, College of Medicine, Chonbuk National University, Jeonju, Korea.|Research Institute of Clinical Medicine of Chonbuk National University-Biomedical Research Institute, Chonbuk National University Hospital, Jeonju, Korea.
authors.forename: Jong Seung
authors.initials: JS
authors.lastname: Kim
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, College of Medicine, Chonbuk National University, Jeonju, Korea.|Research Institute of Clinical Medicine of Chonbuk National University-Biomedical Research Institute, Chonbuk National University Hospital, Jeonju, Korea.
authors.forename: Sam Hyun
authors.initials: SH
authors.lastname: Kwon
mesh_terms: D004724:Endoscopy; D006801:Humans; D009364:Neoplasm Recurrence, Local; D018308:Papilloma, Inverted / Q000473:pathology* / Q000601:surgery*; D010255:Paranasal Sinus Neoplasms / Q000473:pathology* / Q000601:surgery*
keywords: Inverted papilloma; recurrence