Management of nasosinusal inverted papilloma

Inverted papilloma represents a rare histologically benign tumour, characterised by a marked local aggressiveness, by an easy tendency to relapse, and by a possible malignant transformation. Prior to the last twenty years, the standard surgical treatment of the nasosinusal inverted papilloma was almost exclusively extra-nasal, by means of resectioning in block, given the high rate of relapse; only very few cases were treated with low aggressive surgical and not amply destructive techniques. In the last decade, numerous controversies as regards its treatment have arisen, which have seen opposed, on one hand, the followers of the modern techniques of Endoscopic Sinus Surgery (ESS) and, on the other hand, the supporters of more aggressive open procedures. In this article, the experience of the Complex Operative Unit of Otorhinolaryngology of the University Hospital of Messina, joined in a retrospective study of cases of nasosinusal inverted papilloma, operated in the period between 1999 and 2003, is presented. During this period 15 patients affected by nasosinusal inverted papilloma, distinguished according to the Krouse classifìcation, were surgically treated. The follow-up was 24 months. Finally, the Authors report the advantages by Endoscopic Nasosinusal Surgery.