External vs endoscopic approach for inverted papilloma of the sino-nasal cavities: a retrospective study of 136 cases.
Endoscopic removal, with or without external technique, can be performed in a majority of inverted papilloma cases. This method has subsequent recurrence rates that are comparable to those of more aggressive external techniques and it is more cost efficient with less morbidity. To analyze the clinical outcomes of our 21-year experience (1986-2006) in treating inverted papillomas using different treatment modalities. The patients were divided into a conventional surgery group (CSG) and an endoscopic surgery group (ESG) and were staged according to the system developed by Krouse. A retrospective assessment was performed. The recurrence rates were 4.3% in ESG and 9.5% in CSG. There was no significant difference in the recurrence rates according to the treatment modality used and the Krouse stage in the two groups. Mean operation time was 72.93+/-18.51 min in the ESG and 112.02+/-56.52 min in the CSG. Mean period of hospital stay was 4.66+/-1.75 days in the ESG and 9.54+/-4.79 days in the CSG. The complication rate was 3.2% in the ESG and 33.3% in the CSG. There was a significant difference in the operation time, length of hospital stay, and complication rate in the two groups.