The management of sinonasal inverted papilloma: our experience

The inverted papilloma of the nose and paranasal sinuses is a controversial disease. It invades surrounded structures, shows a high recurrence rate after surgical excision and may coexist with squamous cell carcinoma. The use of the optimal surgical approach and technique is of the utmost importance, as it is related to the possibility of recurrence. In cases of tumors of limited size a conservative local excision is sufficient, while, in larger tumors filling the nasal cavity and the paranasal sinuses a more aggressive strategy is needed, such as a medial maxillectomy after lateral rhinotomy. In this paper we present our experience from treating 42 sinonasal inverted papillomas, using a surgical technique which is based on the conservation of as much part of the healthy lateral nasal wall as possible. This modified medial maxillectomy allows us to create a limited in size and normally functioning nasal cavity, thus minimizing the disadvantages of the classical medial maxillectomy without jeopardizing the safety of the operation.