The endoscopic management of sinonasal inverted papillomas

Sinonasal inverted papillomas are well known for high recurrence rates after surgery and the risk of malignant change. Recurrent disease occurs because of inadequate excision as a result of poor exposure and visualization. For these reasons, aggressive surgery has been advocated-classically a lateral rhinotomy and en bloc medial maxillectomy. Endoscopic techniques have provided excellent visualization and a less invasive approach to these tumours. We describe 18 patients with inverted papillomas treated endoscopically at the Singapore General Hospital since 1993. The presentation, sites of involvement and diagnostic imaging are presented. All the patients had a minimum follow-up of 18 months with a mean of 32.8 months. One case of recurrence at the frontal recess is reported. Endoscopic management is appropriate for the diagnosis, follow-up and treatment of circumscribed primary and recurrent inverted papillomas.