经鼻内镜鼻腔鼻窦内翻性乳头状瘤切除术

Endoscopic surgery for sinonasal inverted papilloma

目的:探讨鼻内窥镜下彻底切除鼻腔-鼻窦内翻性乳头状瘤,降低术后复发率的手术方法及其适应证。方法:2006年1月-2009年3月住院的临床及病理诊断为鼻内翻性乳头状瘤的患者68例,采用鼻内窥镜经鼻肿瘤切除或联合上颌窦前壁径路(Caldwell-Luc术式)肿瘤切除术。手术创腔痊愈后1、3、6个月复查,以后随访。全部病例随访12～40个月(平均18.6个月)。结果:68例中2例术后复发,66例未复发,治愈率97.1%。1例复发病例经再次手术后,随诊1年未见复发。结论:未侵及鼻外的内翻性乳头状瘤,均能通过单纯鼻内镜或鼻内镜联合柯-陆术式很好暴露肿瘤根基部,并彻底切除。具体手术方式决定于乳头状瘤根基部所在部位。

Objective：To explore surgical methods in endoscopic approach removing completely nasal sinus inverted papilloma in nasal cavity and sinus for a reduced postoperative recurrence rate,and discuss the operative indications.Methods：68 patients with inverted papilloma in nasal cavity and sinus were treated by nasal endoscopic surgery from 2006 to 2009 in our department.The operation of tumor resection through endoscopy,or a combination with Caldwell-Luc procedure was implemented for the patients.The wound surface after operations was healed,with follow-up after 1,3,and 6 months.All cases were followed up for 12 to 40 months（mean 18.6 months）.Results：Of all the patients,the recovery rate was 97.1%.Recurrence was found in two of the 68 patients,one of whom received the second operation and found no recurrence after 1 year＇s follow-up.Conclusion：Inverted papilloma with non-involved nasal outside can be completely cut through the operation of nasal endoscopy or a combination with the Caldwell-Luc to expose tumor root.The method is determined by the location of the root.