Endoscopic Sinus Surgery for Sinonasal Inverted Papilloma: Our Experience with Medial Maxillectomy


  • Muaid Ismail Aziz University of Sulaimani College of Medicine, Branch of Clinical Science
  • Haval Ahmed Hama University of Sulaimani College of Medicine, Branch of Clinical Science and Smart Health Tower
  • Mariwan Latif Fatah University of Sulaimani College of Medicine, Branch of Clinical Science
  • Soran Omer Hama Sulaimani General Directorate of Health, ENT – Head and Neck Center


Endoscopy, Sinonasal Inverted Papilloma, Maxillectomy


Introduction: Sinonasal inverted papilloma is a non-cancerous growth of epithelial cells commonly found in
the nasal cavity and paranasal sinuses. It predominantly affects adults in their 50s, with a higher occurrence in
males. This condition has a notable recurrence rate and carries a risk of malignant transformation ranging from
5% to 15%.
Objective: This study aims to assess the effectiveness of endoscopic medial maxillectomy as a surgical
intervention for sinonasal IP, focusing on patient outcomes and recurrence rates.
Methods: In a retrospective descriptive cohort study conducted between January 2021 and February 2023 at
Sulaimany Teaching Hospital-Otolaryngology, Head and Neck Surgery Center and Middle East ENT Center at
Zhian Private Hospital, 11 patients were enrolled. Of these participants, 72.7% (8 cases) were male and 27.3%
(3 cases) were female, with a mean age of 45.45 years (range= 23-56). The patients underwent endoscopic
resection for sinonasal inverted papilloma and were assessed using endoscopy, sinonasal outcomes test (SNOT)-
22, radiological imaging, and histopathological examination.
Results: The study included 11 patients who underwent endoscopic resection for sinonasal inverted papilloma.
The examination of these patients revealed a higher prevalence of T2 stage (6 cases) and T3 stage (4 cases)
during the initial diagnosis. Furthermore, one occurrence of recurring disease and one instance of malignant
transformation were documented.
Conclusion: The results underscore the efficacy of modern endoscopic surgical techniques in efficiently treating
inverted papillomas, leading to improved patient outcomes, decreased recurrence rates, and enhanced overall
quality of life following the operation. These advances have successfully eradicated most inverted papillomas
endoscopically, resulting in good quality of life and low recurrence rates


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