Conclusions: The midfacial degloving approach is a favorable option for advanced sinonasal inverted papilloma with a fair recurrence rate, and can replace the lateral rhinotomy approach, which is considered too invasive for benign tumor due to its facial scar. Objective: This study aimed to assess the treatment outcomes of advanced sinonasal inverted papillomas according to surgical approaches over a 20-year period. Material and methods: We retrospectively reviewed clinic, operative, radiologic, and pathologic records of patients with surgically treated sinonasal inverted papilloma, and compared recurrence rates of patients treated with the endoscopic approach, midfacial degloving approach, and lateral rhinotomy approach in each Krouse stage of inverted papilloma. Results: A total of 114 patients were diagnosed and treated surgically for the sinonasal inverted papilloma. The follow-up period ranged from 10 months to 12 years (mean 2.8 years). The overall recurrence rate was 23.7% (27/114). Among the patients classified as Krouse stage III, 33.3% (9/27) of the endoscopic approach group, 11.1% (2/18) of the midfacial degloving approach group, and 25.0% (2/8) of the lateral rhinotomy approach group had recurrences.
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