The tendency of the tumor to recur, its destructive capacity, and its propensity to be associated with malignancy have led to controversy regarding the management of inverting papillomas. Some clinicians view them as benign, some classify them as premalignant, and others regard them as malignant.1 This confusion regarding the clinical features and projected behavior has resulted in a poorly defined clinical approach to the management of these tumors. Some clinicians promote initial conservative procedures for smaller lesions, reserving more radical procedures for large or recurrent lesions.8 The method of surgical management should be dictated by the extent and location of the disease.10

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