Degloving approach for total excision of inverted papilloma

Inverted papilloma, because of its insidious and aggressive clinical course, must be completely excised. Previously, the customary procedure advocated for this goal was a lateral rhinotomy. The degloving approach, which consists of lifting the soft tissues from the mid portion of the face, thereby furnishing unlimited exposure to the pyriform fossae and the lateral nasal walls, offers an excellent alternative to the lateral rhinotomy technique. The degloving procedure involves no external scarring and improves the visibility of the total operative field. En bloc dissection of the lateral nasal wall is then accomplished and extended to include a sphenoethmoidectomy or partial excision of the medial orbital wall, as dictated by the extent of disease. The procedure has been performed by the authors in 46 cases, and has proved to be an extremely valuable technique, displaying excellent cosmetic and functional results with minimal complications.