Comparison of Open versus Endoscopic Resection of Inverted Papilloma

Introduction: The objective of this study was to compare operative parameters, complications, and recurrence rates for open versus endoscopic cases of inverted papilloma (IP) resection.

Methods: Retrospective data analysis was performed on 68 patients with histopathologically confirmed IP treated from January 1983 to May 2005. Parameters for comparison included operative time (OT), estimated blood loss (EBL), length of hospital stay (HS), complications, and recurrence rate.

Results: The average age at time of presentation was 57.4 years with male:female ratio of 2.2:1. Forty-nine patients underwent endoscopic resection, 13 underwent open resection, and 6 underwent limited open resection. Average OT and EBL were statistically similar for the three groups, while the average HS was statistically shorter (p = 0.002) for the endoscopic group. Biopsy-proven recurrence was noted in 11 endoscopic cases (22%), 5 open cases (39%), and 3 (50%) limited open cases. After re-resection, all patients were free of disease. Mean follow-up was 16 months, 56 months, and 69 months for the endoscopic, open, and limited open groups, respectively.

Conclusions: In this series, endoscopic resection of IP was associated with shorter HS and equivalent EBL and OT compared to the open groups. The overall recurrence rate was lower in the endoscopic group with acceptable morbidity compared with the open group.