Abstract: Objective To investigate the surgical strategies for nasal inverted papilloma(NIP)and the corresponding recurrence rates. Methods The clinical data of 181 patients admitted to our hospital from October 2010 to October 2016 with NIP were retrospectively analyzed. All patients underwent nasal endoscopy, computed tomography(CT), or MRI examination before surgery to determine the extent of the disease. Clinical evaluations were made according to the Krouse staging system, and patients were scheduled for surgery. Of those, 124 patients underwent endoscopic sinus surgery, 27 underwent nasal resection, and 30 underwent endoscopic surgery combined with Caldwell-Luc surgery. All were followed up for 1 to 6 years. Results The total postoperative recurrence rate for the 181 NIP patients was 17.7%(32/181). The recurrence rates by surgery type were as follows: endoscopic sinus surgery, 15.3%(19/124); nasal resection, 25.9%(7/27); and endoscopic sinus surgery combined with Caldwell-Luc surgery, 17.7%(32/181). There were no significant differences between the three groups(P>0.05). The recurrence rates for patients with different Krouse staging scores were statistically analyzed. The recurrence rates for grade Ⅰ, grade Ⅱ, grade Ⅲ, and grade Ⅳ lesions were 11.8%(2/17), 11.6%(8/69), 17.2%(11/64), and 35.5%(11/31), respectively. The recurrence rate increased with tumor grade at the time of surgery. There were significant differences in recurrence rates among all stages(P<0.05). Conclusion Endoscopic sinus surgery has become the main treatment for NIP, and the recurrence rate observed was similar to that for endoscopic sinus surgery combined with Caldwell-Luc surgery. The rate of postoperative recurrence increased with the stage of NIP at the time of surgery. Choice of surgical procedure, complete removal of the tumor, and strict follow-up are key to successful treatment.

Key words: Inverted papilloma, Nasal endoscopy, Endoscopy combined with Caldwell-Luc operation, Lateral nasal incision