Researchers conducted this study to analyze and compare the effectiveness of pure endoscopic procedures with external or combined methods to paranasal inverted papillomas, including the experience from two institutions in North Greece over 20 years.

Two thousand four hundred fifty-one patients had been enrolled in the 23 studies published between 1992 and 2014. All the included articles are graded as level IV evidence. Among the 1526 patients of the endoscopic group, 212 had a recurrence, resulting in reproduction to range from 14 to 46.6 months. In the external approach group, 111 of the 592 patients had a recurrence, ranging from 7 to 92 months. The recurrence rate in the combined approach group was 12.9%. The occurrence rate of recurrence attributable to the surgical choice was significantly different between endoscopic and external group (OR: 0.61; 95% CI: 0.40–0.92; P = 0.02; 14.9% vs. 18.8% in endoscopic and external group, respectively).

The present study concluded that the endoscopic approach seems a favorable treatment option for sinonasal inverted papillomas and confirms the global recommendation that is the gold standard in treating such nose lesions, revealing a lower recurrence rate than external approaches.