鼻内窥镜在鼻腔鼻窦内翻性乳头状瘤切除术中的应用

Application of endoscopy sinus surgery in treatment of the inverted papillomas of nasal cavity and paranasal sinuses

目的探讨经鼻内窥镜鼻腔鼻窦内翻性乳头状瘤切除术和鼻内镜联合鼻侧切开鼻腔鼻窦内翻性乳头状瘤切除术的疗效。方法13例鼻腔鼻窦内翻性乳头状瘤病例中经鼻内窥镜鼻腔鼻窦内翻性乳头状瘤切除术10例,鼻内镜联合鼻侧切开鼻腔鼻窦内翻性乳头状瘤切除术3例。结果术后随访13～61个月,平均21个月,13例中12例未复发,治愈率92.3%,1例术后复发,病理检查证实为内翻性乳头状瘤恶变,给予放射治疗。结论经鼻内窥镜鼻腔鼻窦内翻性乳头状瘤切除术适用于较局限的病变;而对广泛病变则应采用鼻内镜联合鼻侧切开术。术后鼻内镜定期复查可早期发现肿瘤复发并处理。

Objective: To investigate the effect of the endoscopic sinus surgery and the combined approach of the endoscopic surgery and lateral rhinotomy in the removal of inverted nasal papilloma of nasal cavity and paranasal sinuses. Methods: Thirteen patients with inverted papilloma of nasal cavity and paranasal sinuses who underwent endoscopic surgical excision or the combined approach of the endoscopic surgery and lateral rhinotomy were analyzed. Results: The follow-up period ranged from 13 to 61 months, with a mean of 21 months. 12 cases were not recurrent. One case which had recurrence after six months was pathologically identified to be papillary adenocarcinoma and was treated with radiotherapy. Conclusion: The endoscopic sinus surgery is proved a better method for treating the limited lesions. The combined approach of the endoscopic surgery and lateral rhinotomy surgery is an effective method for the wide range lesions. Early recurrence would be found through close endoscopic follow-up and could be properly treated.