儿童鼻腔鼻窦肿瘤在内镜辅助下的诊断及手术治疗

Endonasoscope-assisted diagnosis treatment in pediatric sinonasal neoplasm

目的探讨儿童鼻腔鼻窦肿瘤的临床表现以及鼻内镜在其诊治中的应用。方法总结分析13例15岁以下儿童鼻腔鼻窦肿瘤的临床诊治资料。病例均在全身麻醉下行鼻内镜辅助新生物活检或切除术。结果13例中，良性肿瘤9例，其中毛细血管瘤5例，错构瘤1例，神经鞘膜瘤1例，骨瘤1例，鼻咽部血管纤维瘤1例；恶性肿瘤4例，3例为胚胎性横纹肌肉瘤，1例黏液性软骨肉瘤。除2例胚胎性横纹肌肉瘤范围较广未能切除已经死亡外，其余11例均完全切除病变，随访0．5-5年未复发。结论儿童鼻腔鼻窦新生物症状不典型，不易早期诊断。对疑有鼻腔鼻窦新生物的儿童应及早行鼻内镜检查，必要时进行活检，以明确诊断。手术宜采取全身麻醉，术中应用双极电凝可减少出血，低年龄患儿宜使用2．7mm鼻内镜以方便操作。

Objeetive To explore the specialties of sinonasal neoplasm in pediatrics by endoscopy. Methods Clinical data of 13 cases suffering from sinonasal neoplasms were retrospectively analyzed. Results Of the 13 cases, 9 were benign and 4 malignant. All cases were treated or examined by biopsy with an endoscope under systemic anesthesia. 11 cases who had complete removal were followed up without recurrence, and 2 patients who were examined by biopsy died. The mean time from presentation to diagnosis was 12.7 months. Conclusion Early endoscopic removal or biopsy for histological diagnosis, which is performed under systemic anesthesia with bipolar coagulation is necessary.