Management of Inverting Papilloma

"Intranasal approaches have been fraught with recurrences because these tumors are usually bulky, creating a difficult exposure. However, otolaryngologists have been gradually extending the indications for minimally invasive intranasal operations, including endoscopic techniques. Does endoscopic sinus surgery have the potential to lower the high recurrence rate associated with the intranasal approach to that of external techniques, on a consistent basis?"

William R.. Panje

"The only reason to change management philosophy depends on equivalent or improved management techniques. Endoscopic diagnosis and surgery can improve our management of inverted papilloma. The use of endoscopic sinus surgery by experienced surgeons expands the management of inverted papilloma and allows for individualization of treatment."

James A. Stankiewicz

"Many authors do not advocate conservative therapy for the treatment of any inverting papilloma because of the high risk of recurrence and the effectiveness of a medial max-illectomy/lateral rhinotomy."

Steven D. Schaefer

The nasal neoplastic disease entity known as inverting papilloma (IP), also called inverted papilloma, has long been a topic of intense debate because of its recurrent, destructive, and malignant potential. Traditionally, these tumors are approached externally to ensure adequate margins of resection. Intranasal approaches have been fraught with recurrences because these tumors are usually bulky, creating a difficult exposure. However, otolaryngologists have been gradually extending the indications for minimally invasive intranasal operations, including endoscopic techniques. Does endoscopic sinus surgery have the potential to lower the high recurrence rate associated with the intranasal approach to that of external techniques, on a consistent basis? This chapter presents the controversy surrounding the management of IP.

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