Endoscopic management of sinonasal inverted papilloma

Since 1992, 42 patients at the University of Pennsylvania have been treated for inverted papilloma (IP). Thirty-three patients were managed endoscopic ally with or without a Caldwell Luc approach (CLA) and retrospectively anal yzed. The CLA, which involves a gingivobuccal incision for access to the ma xillary sinus, is distinguished from a formal Caldwell Luc procedure. These 33 patients with histologically confirmed IP were without evidence of mali gnancy. They also did not have evidence of intracranial, orbital, or fronta l sinus IP. Seventeen of 33 patients (17/33) were without prior treatment ( primary). Sixteen of 33 (16/33) presented from an outside institution with recurrent IP (secondary). The recurrence rate rising this method to treat p rimary IP was 6% (1/17), and for secondary IP was 25% (4/16). Scheduled pos toperative endoscopic surveillance permitted early detection of recurrence and continued endoscopic control of IP. All 33 patients were endoscopically free of disease at the end of the study. These preliminary data ape encour aging for the use of intranasal endoscopy with and without CLA as a means o f managing and controlling IP in selected cases.