放射性鼻窦炎的手术治疗

Effect of surgery on irradiation-induced rhinosinusitis in patients with nasopharyngeal carcinoma

目的探讨鼻内镜下手术治疗鼻咽癌(NPC)放射治疗后放射性鼻窦炎的疗效。方法笔者对2005年9月～2008年9月收治的经保守治疗无效的37例放射性鼻窦炎患者(放疗后10个月至8年)行鼻内镜手术治疗,术后随访12～36个月,观察其疗效。结果 37例NPC放射治疗后鼻窦炎患者治愈15例(40.5%),有效20例(54.1%),无效2例,总有效率为94.6%。结论对保守治疗无效的放射性鼻窦炎患者行鼻内镜手术是一种行之有效的治疗方式。

Objective To investigate the effect of endoscopic sinus surgery combined with other adjunctive therapy on irradiation - induced rhinesinusitis in patients with nasopharyngeal carcinoma （ NPC ）. Methods 37 NPC patients with irradiation - induced sinusitis hospitalized from September 2005 to September 2008 were enrolled in the study. All patients were treated with endoscopic surgery combined with other adjunctive therapy and followed up for 12 to 36 months. The surgery was performed 10 months to 8 years after the irradiation therapy. Results 15 cases （40.5%） were completely cured, 20cases （54. 1% ） were improved and 2 cases were ineffective. The total effective rate （including the cured and improved cases ） was 94.6%. No recurrence was observed. Conclusion Endoscopic sinus surgery is an effective method in the treatment of irradiation-induced rhinosinusitis in patients with nasopharyngeal carcinoma. The key points to enhance the curative effect include the reservation of the useful mucosa and appropriate postoperative therapy.