Lateral rhinotomy vs mid-facial degloving for T3 inverted papilloma of nose and paranasal sinus.

Inverted papillomas are rare, benign epithelial tumours of the nasal cavity and paranasal sinuses. To evaluate recurrence rates and rates of malignant transformation by lateral rhinotomy and midfacial degloving approaches for inverted papillomas. Retrospective case series, done at Manipal Teaching Hospital, Pokhara, over an 8-year period from 2000 to 2008. We did a review of 20 cases of T3 inverted papilloma. All patients initially underwent nasal biopsy for confirmation of the diagnosis and pre-operative C.T. scan for tumour staging. 10 patients who had a medial maxillectomy by lateral rhinotomy approach were assigned group I, while 10 who had a medial maxillectomy by mid-facial degloving approach were placed under group II. There were 7 males and 3 females in both group I and group II. Age ranged from 50 to 70 years with a mean age of 62.3 years for group I and 59.8 years for group II. Commonest presenting complaint was unilateral nasal obstruction (60.0% in group I, 80.0% in group II). The mean follow up period was 19.5 months for group I and 16.5 months for group II. Recurrence rate and malignant transformation was 10.0% each for both groups. There was no significant difference between the 2 groups in these findings. Lateral rhinotomy and mid-facial degloving approaches have similar recurrence rates in T3 inverted papillomas but mid-facial degloving has the advantage of no external facial scar and bilateral exposure.