鼻内镜在鼻内翻性乳头状瘤手术中的术式探讨

Investigation of Endoscopic Surgery for the Treatment of Nasal Inverted Papilloma

目的探讨鼻内镜下彻底切除鼻内翻性乳头状瘤术式。方法对23例鼻内翻性乳头状瘤患者（25侧），根据鼻内镜、CT检查，确定肿瘤的范围，采用鼻内镜经鼻切除10例（12侧），经鼻切除同时加上颌窦前壁开窗联合径路肿瘤切除13例（13侧），全部病例随访12～46月（平均23．8月）。结果23例中，术后2例（3侧）复发。1例鼻内镜下去除病灶基底部微波热凝，1例行鼻侧切开鼻内镜下肿瘤切除，随访1年未复发。结论术前根据鼻内镜、CT检查，确定肿瘤的范围，准确的肿瘤分级，选择合理的术式是减少肿瘤复发的关键。

Objective To investigate the method of endoscopic surgery for the treatment of nasal inverted papilloma. Methods The clinical data of 23 cases （25 sides） of nasal inverted papilloma were retrospectively analyzed in our department between January 1998 and June 2005. The tumor＇s extent was decided by nasal endoscopy and CT scan. The tumors of 10 cases （12 sides） were excised by endoscopic surgery from nose, and 13 cases （13 sides） were excised by co-paths of the endoscopic surgery from nose and anterior wall of maxillary sinus. The period of follow-up was 12-46 months. Results 2 cases （3 sides） recurred. They were re-operated by endoscopic surgery and do not recur in 1 year. Conclusion The key points of reducing recrudescence of nasal inverted papilloma lie in deciding the tumor＇s extent by nasal endoscopy and CT scan, precise tumor grading, and choosing right operating methods.