[Endoscopic surgery for nasal inverted papilloma]

To study and perfect the endoscopic surgery for nasal inverted papilloma(IP) and to decrease the recurrence after operation.

Forty-seven cases who were diagnosed as nasal IP were divided into two groups according to the tumor extension and operated upon and observed for 12-40 months (average 24.6 months). 51% of all cases had been operated on for 1-3 times before the treatment. Thirty-six cases in which the tumor had invaded the lateral nasal wall, middle meatus, partial or total ethmoid and/or sphenoid and infiltrated around the natural ostium of the maxillary sinus had performed transnasal endoscopic surgical procedures(TNESP). Another group (9 cases) in which involvement of the IP had further extended, into the maxillary sinus, had been treated by combination transnasal and Caldwell-Luc endoscopic surgical procedures (CTESP). In order to decrease bleeding during the operation, the body and bases of the IP were irradiated with YAG laser. The tumor was removed using the shaver system. The bony attachment of the IP and neighboring tissues were irradiated in all cases.

Forty-five (95.7%) cases were not recurrent. The recurrence of the IP was identified in two cases (4.3%). But in 6 cases (12.8%), during postoperative follow-up management (1-3 months postoperatively) small mass of the IP (pathologically identified) were observed and removed and irradiated with YAG laser immediately. The recurrence was not observed in the one year follow-up period.

Endoscopic surgical technique combining the irradiation of YAG laser and the application of shaver system is recommended. This procedure was effective and led to a decreased recurrence rate.