We report clinical outcomes in 47 cases of surgically resected inverted maxillary sinus papilloma between 1998 and 2007. Surgery involved 1 broadening the endoscopic surgical field by partially dissecting the tumor in marked bleeding or microdebriding the tumor ; 2 identifying tumor origin ; and 3 excision. Endoscopic sinus surgery ESS was done in 29 cases and endoscopic transmaxillary surgery ETMS in 18. Recurrence occurred in 4 cases due, we beliere to insufficient intraoperative origin identification and excision. Neither piecemeal resection nor microdebrided tumor reduction disseminated tumor cells or relapse. Our results thus clearly indicate that surgery should focus on the identification and excision of the tumor origin rather than on tumor bulk resection as is conventionally done.
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