侵入颅内的鼻腔和鼻窦内翻性乳头状瘤

The nasosinus inverted papilloma with intracranial extension

目的 :探讨治疗侵入颅内的鼻腔、鼻窦内翻性乳头状瘤 (NIP)的方法。方法 :9例NIP患者均行手术治疗。 6例侵犯前颅窝硬脑膜及脑组织的较大肿瘤行颅面联合进路或经颅进路肿物切除术 ,3例侵犯颅内较小的肿瘤经额筛窦径路切除。对术中颅底骨质缺损或硬脑膜切除者可同步修补。 5例术后病理证实癌变者均补充放射治疗。结果 :7例随访 3～ 13年 ,无一例复发。结论 :对于侵入颅内的NIP应充分考虑到其恶变的可能性 ,可根据肿瘤大小、侵犯范围行颅面联合进路或经额窦内板切除术 。

Objective:To study the treatment of inverted papilloma (NIP) with intracranial extension.Method:Nine patients of NIP all suffered from the operation.Six patients with anterior skull base erosion suffered from large tumor resections via combined craniofacial and cranial approach. Three patients suffered from small tumor resections via transfrontal and transethmoidal sinus approach. The defects of basicranial bone and dura were repaired at the same time.Five patients were found the tissue canceration in the postoperation.Result:In 7 patients followed up from 3 to 13 years,no one has recurrenced.Conclusion:The canceration probability of NIP with intracranial extension should be sufficiently considered. The tumor resection via combined craniofacial approach or transfrontal approach must be based on the tumor size and extension, and removed completely.