Endoscopic medial maxillectomy as a procedure of choice to treat inverted papillomas

Abstract

Conclusions: Endoscopic medial maxillectomy (EMM) is a safe, effective method for the treatment of inverted papillomas (IPs) of the paranasal sinuses. Objective: To evaluate the efficacy of EMM as a surgical technique in the treatment of IP compared with non-endoscopic techniques. Patients and methods: This was a retrospective study of 52 patients with an IP diagnosed by biopsy from 1990 to 2004. EMM was performed in 34 patients (65.4%), whereas non-endoscopic techniques were used in 18 (34.6%). The mean duration of follow-up was 54.2 months. Results: Recurrence occurred in 4 of the 34 patients who underwent EMM (11.8%; 95% confidence intervals (CI) = 39 at 26%) and in 8 of the 18 patients treated using non-endoscopic techniques (44.4%; 95% CI = 23.2 at 67.3%). There was a statistically significant difference (p<0.05) between treatments, assessed by Kaplan–Meier estimator and log-rank testing. Of the 12 patients who suffered a recurrence, 6 (50%) were treated with endoscopic surgery, 4 (33%) with mediofacial degloving and 2 (17%) were merely followed up; no malignant degeneration occurred.

• Endoscopic sinus surgery
• inverted papilloma
• otorhinolaryngologic surgical procedures