A Clinical Study of Inverted Papilloma in the Nasal Cavity and Paranasal Sinuses

We conducted a retrospective clinical study of inverted papilloma in the nose and paranasal sinuses in 26 cases (28 sides) of inverted papilloma in the last 10 years. The subjects were 17 men and 9 women with a mean age of 54.6 years. Follow-up averaged 11 months to 10.4 years with a mean of 69.4 months (5.8 years) . Surgical excision is generally regarded as the treatment of choice for papilloma, however, the approach and extent of surgery have been much debated. We clarified the relationship between surgical invasion and disease recurrence. Six of 28 sides developed recurrence (21.4%), none developed malignant transformation, and 2 of 26 cases (7.7%) were diagnosed as with bilateral papillomas. In the endoscopic group, 2 of 8 cases (25.0%) recurred, compared to 4 of 20 cases (20.0%) in the non-endoscopic group. The amount of blood lost was significantly smaller in the endoscopic group. All 8 cases with aggressive endoscopic resection manifested no recurrence and minimum blood loss. We concluded that aggressive endoscopic resection is the best treatment in terms of recurrence rate and surgical invasion. In general, this approach is preferable for tumors in the nasal cavity or in those localized with a clear endoscopic view in the paranasal sinuses.