鼻内镜下上颌骨内侧壁切除联合经鼻腔泪道置管治疗上颌窦内翻性乳头状瘤

Endoscopic medial maxillectomy in combination with lacrimal passage implantation of tube for sinonasal inverted papilloma invading maxillary sinus

目的探讨鼻内镜下上颌骨内侧壁切除联合经鼻泪道置管,在上颌窦内翻性乳头状瘤手术中的应用价值。方法回顾分析2006年1月至2010年10月采用鼻内镜下上颌骨内侧壁切除联合经鼻泪道置管治疗32例上颌窦内翻性乳头状瘤患者的临床资料。术中切除上颌骨内侧壁,彻底切除上颌窦肿瘤,经鼻泪道置入硅胶管,术后长期随访。结果 32例患者均为Krouse分期T3期,全部彻底切除肿瘤,术后随访12～72个月,平均35个月,术腔上皮化良好,2例复发,复发率为6.3%,局部清除后随访未再复发,患者均无溢泪并发症。结论鼻内镜下上颌骨内侧壁切除是治疗Krouse分期T3期上颌窦内翻性乳头状瘤的良好术式,术中联合经鼻泪道置管可以预防泪道狭窄。

Objective To evaluate the efficacy of endoscopic medial maxillectomy in combination with lacrimal passage implantation of tube for sinonasal inverted papilloma invading maxillary sinus.Methods From January 2006 to October 2010,32 patients with sinonasal inverted papilloma invading maxillary sinus received endoscopic medial maxillectomy in combination with lacrimal passage implantation of tube in our hospital.The clinical data of the patients were analyzed retrospectively.Results All the tumors were in T3 Krouse stage and were thoroughly excided.2 cases had recurrence and were cured after local debridement.The overall recurrence rate was 6.3%（2 of 32）.Followed up from 12 to 72 months,all of the patients had no epiphora and other complications.Conclusion Endoscopic medial maxillectomy is a good technique for maxillary sinus inverted papilloma of T3 Krouse stage,and lacrimal passage implantation of tube can be used to prevent stenosis of nasolacrymal duct.