Aggressive endoscopic resection of inverted papilloma: An update

Objective: Endoscopic resection has been proposed for sinonasal inverted pa pilloma (IP). Our objective was to determine the efficacy of aggressive end oscopic resection of IP. Methods: Retrospective analysis was performed on patients undergoing endosc opic resection of IP at the University of Virginia between 1990 and 1996. T otal ethmoidectomies, wide maxillary antrostomies, frontal recess explorati ons, sphenoidotomies, and turbinate resection were performed as required. O nce all visible papilloma was removed, residual mucosa was removed by using a diamond burr to polish bone at the site of origin. Results: Twenty-one patients were treated with endoscopic resection of IP. Only 1 of 21 patients had an adjunctive external procedure (an osteoplastic flap without obliteration). Average follow-up was 41.9 months after initia l aggressive endoscopic resection at the ureterovesical angle. Recurrences occurred in 19% (4/21) of patients. One of the 4 had two recurrences. Recur rences occurred in 16 months or less, except for one noted at 35 months and another at 56 months. Conclusions: Aggressive endoscopic resection of IP by experienced rhinologi sts is an acceptable treatment.