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Role of endoscopic approach in the management of inverted papilloma

Carta, Filippo; Verillaud, Benjamin; Herman, Philippe

Current Opinion in Otolaryngology & Head and Neck Surgery: February 2011 - Volume 19 - Issue 1 - p 21–24
doi: 10.1097/MOO.0b013e3283425213
Nose and paranasal sinuses: Edited by Anshul Sama

Purpose of review The aim of this work, based on a recent review of the literature concerning sinonasal inverted papilloma, is to describe the diagnostic strategy for inverted papilloma and to propose an algorithm for the choice of surgical techniques, based on recent results of clinical series.

Recent findings Traditionally, inverted papilloma was managed through an open approach. Endoscopic techniques have been developed, first combined with an open approach, and then exclusively endoscopic with the advent of medial maxillectomy and median drainage or Draf procedures. Numerous case series strongly support that they now represent the treatment modality of choice.

Summary This is a review concerning recent findings about inverted papilloma, based on recent literature revision.

Diagnosis of inverted papilloma has to be made before surgery, and planning of the surgical strategy is based on the comparison of computed tomography and MRI, with the aim of targeting the insertion of the tumor. With the help of expanded surgical procedures, endoscopic surgery has become the gold standard for the treatment of the vast majority of inverted papilloma. In case of massive frontal or supraorbital extensions, the frontal osteoplastic flap is the complementary approach of choice.

Department of Ear, Nose and Throat, Hôpital Lariboisière, AP-HP, Paris, Université Paris-Diderot, Paris, France

Correspondence to Professor Philippe Herman, MD, PhD, Hopital Lariboisiere, Service ORL, 2, rue Ambroise Paré, 75010 Paris, France Tel: +33 1 49 95 80 48; fax: +33 1 49 95 80 63; e-mail:

© 2011 Lippincott Williams & Wilkins, Inc.