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Abstract
Endoscopic surgery is a viable treatment alternative in the surgical armamentarium of management of inverted papilloma. However, larger patient populations and longer follow-up periods are needed for more definitive results. Furthermore, there are compulsory preconditions for successful endoscopic surgery of the inverted papillomas such as good preoperative staging, a surgeon experienced in this technique, adequate endoscopic equipment, and a close follow- up of the patients.
Before considering endoscopic surgery, the patient must be informed about the nature of the disease and the necessity of a close follow-up. Furthermore, the patient must know that the endoscopic approach may be combined with a radical surgery. The choice of the surgical approach should be made according to the location and extension of the tumor and experience of the surgeon; so far there has been no consensus about the exact indications of endoscopic surgery.
Long-term endoscopic surveillance and frequent follow-up care are crucial, regardless of the surgical technique used. Treating disease recurrence early may prevent malignant transformation. Recurrence is mostly detected endoscopically in 12-20 months but reported as late as 30-56 months.