Abstract: To explore whether endoscopic surgery united with external approach surgery can cut down the recurrence rate of sinonasal inverted papilloma. Methods: A retrospective analysis was performed for 81 cases treated in our department from January 2000 to January 2006. All the cases were divided into two groups according to the stage: the group of the former stage from January 2000 to January 2003 and the group of the later stage from January 2003 to January 2006. Thirtysix cases of the former stage were mostly operated with nasal endoscopy, whereas fortyfive cases of the later stage were selectively operated with nasal endoscopy united with external approach surgery. The recurrence rate of the two groups in the same Krouse grade was compared. Results: There was no difference between the two operating methods in the cases of Krouse Ⅰand Krouse Ⅱ. But in Krouse Ⅲ, the recurrence rate of those underwent nasal endoscopy united with external approach was lower than that of those only underwent nasal endoscopy. Conclusion: For the cases of Krouse Ⅲ, the external approach is a good supplementary for the surgery under nasal endoscope. Be used nasal endoscope united with external approach surgery, the tumor can be excised more thoroughly, so residual and recurrence, as well as impairment can be cut down.

Key words: Endoscopy, External approach , Inverted papilloma