鼻内镜手术治疗鼻腔鼻窦内翻性乳头状瘤

Endoscopic surgery for sinonasal inverted papilloma

目的总结鼻内镜下治疗鼻腔鼻窦内翻性乳头状瘤的手术技巧及远期疗效。方法对2000年7月～2007年10月67例住院治疗的鼻腔鼻窦内翻性乳头状瘤患者资料进行回顾性分析。根据病变范围及分期情况,采取标准式鼻内镜手术、扩大式鼻内镜手术或鼻内镜联合鼻外进路手术,术后随访4～10年,并观察远期疗效。结果术中可达到内镜直视下切除肿瘤,全部病例无发生严重并发症,随访统计标准式鼻内镜手术病例35例,其中复发5例;扩大式鼻内镜手术17例,其中复发2例;联合进路15例,其中复发2例。总复发率为13.4%(9/67)。结论鼻内镜手术是治疗鼻腔鼻窦内翻性乳头状瘤安全、有效的方法,根据病变范围及分期选择合适的手术方式并保证肿瘤在明视下切除是临床需要注意的问题。

[Objective] To study the long-term effects of endoscopic surgery for sinonasal inverted papilloma. [Method] A retrospective review of 67 patients with a diagnosis of sinonasal inverted papilloma treated by endoscopic surgery was carried out. Three surgery options as standard endoscopic surgery,extended endoscopic surgery and combining endoscopic surgery with external approaches were performed according to tumor extension assessed preoperatively by endoscopic examination and computer tomography （CT）. All patients were followed up for 4～10 years. [Result] All the lesion could be excised under endoscopy without any complications. Recurrence in 5 patients out of standard surgery group （35 cases）, 2 patients out of extended surgery group （17 cases）, 2 patients out of combining surgery group （15 cases）, with a total recurrence rate of 13.4% （9/67）. [Conclusion] Endoscopic surgery was safe and effective treatment for sinonasal inverted papilloma, long-term recurrence rate was 13.4%. Surgery approaches should be carefully selected according to locations and extension of the tumors, and make sure that surgery be performed in endoscopic visual fields.