上颌窦源性的鼻腔内翻性乳头状瘤术式的选择与探讨

Study of Different Surgical Approach of Nasal Inverted Papilloma Orgine Maxillary Sinus

目的:探讨上颌窦源性鼻腔内翻性乳头状瘤的手术方式。方法:回顾性分析83例上颌窦源性鼻腔内翻性乳头状瘤的临床资料,比较传统的鼻侧切开术或上颌窦根治术与鼻内镜下经泪前隐窝入路上颌窦内翻性乳头状瘤切除术的术后复发率及并发症。结果:49例经传统鼻侧切开术或上颌窦根治术的术后复发率为8.1%,术中出血量平均150ml,部分患者术后有损容貌、溢泪等并发症。34例在鼻内镜下经泪前隐窝入路完整切除肿瘤,术后复发率为8.8%,术中出血量平均100ml,无并发症出现。结论:在鼻内镜下经泪前隐窝入路切除上颌窦源性的鼻腔内翻性乳头状瘤较传统的鼻侧切开术或上颌窦根治术具有相同术后复发率且手术创伤小,安全,术野清楚,术后并发症少等优点,值得临床推广。

Objective： The purposes of this study were to find different approach of maxillary sinus surgery with nasal inverted papilloma. Methods：Via retrospective analysis of 83 cases with nasal inverted papilloma. We compared the complications and relapse rate of different cases with different surgical approach, which including traditional surgery such as nasal incision or radical maxillary surgery and recess affront of the nasolacrimal duct by endoscopic.Results：49 cases were accepted traditional surgery while 34 patins＇ lesions were cut passing through the recess affront of the nasolacrimal duct under endoscopic. Relapse rate of traditional surgery was 8.1% while the latter was 8.8%. The average amount of bleeding were150ml compared to 100ml. Although there are similar relapse rate of those above different surgeries.Conclusions：The endoscopic surgery via recess affront of the nasolacrimal duct was Jess amount of bleeding, appearance damage, and more safer than traditional sugary. Taking into account of those advantages, the endoscopic surgery is worthy promoting.