Experience in endonasal endoscopic surgery of the inverted papilloma of the nose and the paranasal sinuses.

Background: The inverted papilloma of the nasal cavity and the paranasal si nuses is a benign but locally aggressive neoplasm with a high recurrence ra te and an unknown risk of malign transformation. This unsteadiness of biolo gical behaviour requires a permanent control of the outcome of the availabl e surgical treatments to ensure the utmost reliability for the patients. Me thods: In our investigation we analysed the surgical results in 54 patients with inverted papilloma of the last 30 years with an average followup of 5 5 months. 25 of them were endoscopically treated. The other group of 29 pat ients was treated by traditional surgical techniques using an extranasal ap proach. Results: Using the endonasal-endoscopic technique we observed a rec urrence rate of 48% whereas the other group treated by an extranasal approa ch reached a recurrence rate of only 24% and did not show any multiple recu rrences. A malign transformation was found in two patients (< 5 %) within t he first 8 months after the first resection. Conclusion: In consequence pat ients with inverted papilloma have to be informed of the different surgical techniques and their recurrence rates. Especially an endonasal-endoscopic treatment of the maxillary sinus has to be carefully considered.