Conservation surgery for inverted papillomas

To evaluate the role of conservation surgical treatment of inverted papillomas of the nose and paranasal sinuses, the clinical course of 46 patients treated during a 10-year period was evaluated. Twelve patients were noted to have either invasive squamous cell carcinoma or carcinoma in situ and were excluded from analysis. Of the remaining 34 patients, 19 had previous treatment for inverted papilloma. Subsequently, 20 patients were treated with lateral rhinotomy and medial or partial maxillectomy. Fourteen patients were treated with conservation surgical therapy. There were 5 recurrences (15%), which all occurred in the conservation-treated group. Four of six (66%) patients treated with an intranasal procedure recurred but only 1 of the 8 (12%) patients treated with a Caldwell-Luc approach combined with an intranasal procedure. Successful treatment was achieved in all patients undergoing salvage surgery for recurrence. The role of conservation treatment in the management of inverted papillomas of the nose and paranasal sinuses is discussed.