Sinonasal inverted papilloma: 84 patients treated by endoscopy and proposal for a new classification

Aim: To suggest a new classification system for sinonasal papilloma based on a critical analysis of surgical indications and results obtained. Methods: We analysed surgical data from 84 cases of sinonasal papilloma treated endoscopically. Results: In 58 males and 26 females, between 25 and 85 years, the ethmoid sinus (63 cases), the maxillary sinus (43), and the nasal fossa (22) were mostly involved. No case of endocranial extension or carcinoma was reported. Complications were reported in 15.4% of patients, as well as 5 recurrences (5.9%). Median follow up was 39,5 months. To categorize the tumour for the most appropriate surgical treatment, we propose a classification based on 6 main categories that depend on the location, origin and extension of the tumour. Conclusion: The classification that we propose presents advantages for prognosis and surgical indication in comparison with other classifications.