Long-Term Outcomes of Transnasal Endoscopic and Extranasal Management in Inverted Papilloma of Nasal Cavity and Paranasal Sinuses

Kim, Yong Dae; Park, Jun Chul; Chi, Deok Hwan; Chang, Keun Young; Cho, Gil Sung; Bai, Chang Hoon; Song, Si Youn

Abstract

BACKGROUND AND OBJECTIVES:Extranasal approach has been emphasized treatment of choice in inverted papilloma of nasal cavity and paranasal sinuses until several years ago. However, nowadays conservative transnasal endoscopic surgery is done in properly selected cases of inverted papilloma. The aim of this study was to compare the long-term outcomes of transnasal endoscopic and extranasal surgical management of inverted papilloma.
MATERIALS AND METHODS
Among 33 patients who were pathologically diagnosed as inverted papilloma from January 1990 to August 1997, we reviewed the medical records and CT scans of 25 patients who underwent surgical treatment and were available for the follow up at least more than 2 years, retrospectively.
RESULTS
Thirteen patients were treated via transnasal endoscopic approach and twelve patients by extranasal approach. According to Skolnik(1966)'s stage classification, 20 patients showed stage T3. Eleven patients of them were treated via transnasal endoscopically and 9 patients extranasally. Four minor postoperative complications, such as epiphora, septal perforation, vestibular pain and facial parasthesia, were noted in extranasal approach group. One case(7.7%) recurred in conservative transnasal endoscopic surgery group during mean 38 months follow up period. However, no recurrence was found in extranasal approach group during mean 60 months follow up period.
CONCLUSION
If endoscopic surgery is performed by experienced surgeons in adequately selected patients, conservative transnasal endoscopic surgery can be considered as an alternative surgical modality in inverted papilloma of nasal cavity and paranasal sinuses.