鼻腔鼻窦内翻性乳头状瘤的术式选择

The Rational Surgical Approach of The Nasal Inverted Papilloma

目的探讨鼻腔鼻窦内翻性乳头状瘤(NIP)的术式选择,从而减少其复发率。方法 78例患NIP行手术治疗,并随访资料完整者,用统计方法对不同术式复发率进行分析。结果总复发率17.9%,单纯鼻内镜手术组复发率10.0%,鼻内镜+柯陆术复发率19.2%,鼻侧切组复发率41.6%。初次手术复发率14.8%,复发病例的手术复发率25.0%。结论①合理选择适应证的前提下鼻内镜手术较传统手术具有明显优势。②复发病例不是鼻内镜手术禁忌,根据病变范围选择术式。③手术者的经验和水平,病变的范围和程度,合理的术式选择与复发有关,完全彻底切除肿物是手术成功关键。

Objective The rational surgical approach of the nasal inverted papilloma（NIP） were researched.Methods 78 patients suffering from NIP were treated by surgery.Among these patients,40 cases were treated by endoscopically,26 cases were treated by endoscopic combined with Caldwell-luc,12 cases were treated by lateral rhinotomy.All post operative cases were followed up.Results Over all recurrence rate was 17.9%（14/78） ,The recurrence rate for endoscopic group was 10.0%（4/40） ,endoscopic combined with Caldwell-luc was 19.2%（5/26） ,lateral rhinotomy approach was 41.6%（5/12） Conclusion ①The endoscopic surgical was proved to be an effective management for treating NIP;②For recurrent cases,according to the tumor extension,selected the rational surgical approach;③The recurrence can be related with surgeons＇s technique,extension of the tumor and rational surgical approach.Complete removal tuomr is the key to a successful outcome.