Background: A benign tumor that originates from the Schneiderian mucosa of the nasal cavity and paranasal sinuses is known as a sinonasal inverted papilloma (IP). It demonstrates locally aggressive growth, a tendency for postoperative recurrence, and a recognized potential for malignant transformation in approximately 5–15% of cases. Complete surgical excision with precise identification and removal of the point of tumor attachment is essential for management, especially for lesions in the maxillary sinus. In the past, external approaches were commonly used to ensure sufficient exposure but were linked to significant morbidity.
Objective: To summarize the evolution of endoscopic medial maxillectomy (EMM) for sinonasal IP, focusing on anatomy-preserving strategies and their clinical outcomes.
Methods: This narrative review summarizes the evolution of EMM for sinonasal IP, with emphasis on anatomy-preserving modifications designed to maintain nasal physiology while ensuring adequate tumor resection.