Endoscopic surgical management of sinonasal inverted papilloma extending to the frontal sinuses

Objective: Sinonasal inverted papilloma has been traditionally managed with external surgical approaches. Advances in imaging guidance systems, surgical instrumentation, and intraoperative multi-visualization have led to a gradual shift from external approaches to endoscopic surgery. However, for anatomical and technical reasons, endoscopic surgery of sinonasal inverted papilloma extending to the frontal sinuses is still challenging. Here, we present our experience in endoscopic surgical management of sinonasal inverted papilloma extending to one or both frontal sinuses. Methods: We present 10 cases of sinonasal inverted papilloma extending to the frontal sinuses and successfully removed by endoscopic median drainage (Draf III procedure) under endoscopic guidance without any additional external approach. Results: The whole cavity of the frontal sinuses was easily inspected at the end of the surgical procedure. No early or late complications were observed. No recurrence was identified after an average follow-up period of 39.5 months. Conclusion: Use of an endoscopic median drainage approach to manage sinonasal inverted papilloma extending to one or both frontal sinuses is feasible and seems effective.