鼻内镜手术治疗鼻腔鼻窦内翻性乳头状瘤

The Application of Endoscopic Sinus Surgery for Sinonasal Inverted Papilloma

目的探讨鼻内镜手术治疗鼻腔鼻窦内翻性乳头状瘤的方法及可行性，观察其疗效。方法回顾性分析2008年1月～2012年12月57例鼻腔鼻窦内翻性乳头状瘤的临床资料，均行鼻内镜下切除手术。根据病变程度和范围，选择经典式鼻内镜手术，鼻内镜中鼻道、下鼻道联合上颌窦开窗术，鼻内镜辅助下Caldwell—Luc手术。观察术后复发率。结果随访1～3年，（23±9）月。复发率10．5％（6／57），其中经典式鼻内镜手术9．7％（3／31），鼻内镜中鼻道、下鼻道联合上颌窦开窗术10．0％（2／20），鼻内镜辅助下Caldwell—Lue手术16．7％（1／6）。复发6例均行二次鼻内镜手术，随访6—12个月，平均7．5月，无再次复发。结论鼻内镜下手术治疗鼻腔鼻窦内翻性乳头状瘤手术损伤小，术后复发率低，临床疗效较好。

Objective To explore the feasibility and effect of nasal endoscopic surgery for sinonasal inverted papilloma. Methods The clinical data of 57 cases of sinonasal inverted papillomas in nasal cavity and sinus undergoing nasal endoscopic surgery from January 2008 to December 2012 were retrospectively analyzed. Based on the degree and scope of lesion, the surgical procedure was chosen from the classic nasal endoscopic surgery, inferior and middle nasal meatus endoscopy combined with maxillary sinus fenestration and Caldwell-Luc surgery under nasal endoscopy. The postoperative recurrence rate was observed. Results All the cases were followed up for 1-3 years, （23 ±9） months. The total recurrence rate was 10.5% （6/57）. The recurrence rate was 9.7% （3/31） in classic nasal endoscopic surgery, 10.0% （2/20） in inferior and middle nasal meatus endoscopy combined with maxillary sinus fenestration, and 16.7% （1/6） in Caldwell-Luc surgery under nasal endoscopy. The 6 recurrent cases received secondary nasal endoscopic surgery and were followed up for 6 -12 months （average, 7.5 months）. No recurrence was found in the follow-up. Conclusion Nasal endoscopic surgery for the treatment of nasal sinus inverted papilloma is minimally invasive and has low recurrent rate.