鼻内镜下鼻腔鼻窦内翻性乳头状瘤切除术

Endoscopic surgery in sinonasal inverted papillomas

目的：探讨鼻内镜下鼻腔鼻窦内翻性乳头状瘤切除术的疗效及应用价值。方法：回顾性分析1999年7月-2005年4月诊治的有完整随访资料的40例经鼻内镜手术治疗的鼻腔鼻窦内翻性乳头状瘤患者的临床资料。结果：所有病变均一次完全手术切除,5例患者接受术后放疗。无严重并发症发生。术后随访24-93个月,平均45.1个月,6例复发,其中3例恶变,3例死亡。复发时间18-58个月,平均37.3个月。结论：经鼻内镜手术治疗鼻腔鼻窦内翻性乳头状瘤安全、有效、微创,彻底切除肿瘤、术后定期随访是治疗成功的关键。

Objective：To evaluate the effect and application value of endoscopic resection in sinonasal inverted papillomas.Method：In a retrospective study, clinical data of 40 patients underwent transnasal endoscopic approach in Chinese PLA General Hospital from July 1999 to April 2005 were analyzed. Tumor stage according to Krouse was T1： 4, T2： 23, T3： 12, T4： 1, respectively.Result：All lesions were removed completely and 5 patients received post-operative radiation therapy. There were no serious complications occurred. The follow-up period ranged from 24 to 93 months （mean, 45.1 months）. Recurrence rate was 15% （6/40） and the rate of malignant transformation and mortality were 7.5 % （3/40）, respectively. Average time to recurrence was 37.3 months.Conclusion：Endoscopic surgery offers a safe and effective treatment for sinonasal inverted papillomas with a minimally invasion. Thorough removal of the tumor and regular follow-up are the key points for success.