鼻内镜或鼻内镜辅助手术治疗鼻腔鼻窦内翻性乳头状瘤116例临床分析

Clinical analysis on the therapeutic effect of nasal endoscopic or endoscope-assisted surgery on nasosinous inverting papilloma among 116 cases

目的 观察鼻内镜手术治疗鼻腔-鼻窦内翻性乳头状瘤的疗效。方法 回顾性分析2002年1月~2008年1月接受鼻内镜手术治疗的鼻腔-鼻窦内翻性乳头状瘤患者临床资料。其中单纯鼻内镜手术80例,鼻内镜联合改良Caldwell-Luc术式33例,鼻内镜联合鼻侧切开术式3例。术后随访6~12年。结果 所有病例均经术后病理证实为鼻腔-鼻窦内翻性乳头状瘤,其中5例发生恶变。随访结果显示,术后复发14例（12.06%）,包括Ⅱ级5例（5/62,8.06%）、Ⅲ级8例（8/27,29.63%）、Ⅳ级1例（1/6,16.67%）。结论 应根据病变的原发部位及其侵及范围采取恰当的手术方式以提高治愈率,减少复发。

Objective To evaluate the therapeutic effect of nasal endoscopic or endoscope-assisted surgery on nasosinous inverting papilloma among 116 cases. Methods A retrospective analysis was carried out among patients with nasosinous inverting papilloma, treated in our department from Jan, 2002 to Jan, 2008, with their clinical data analyzed carefully. Among them 80 were treated by simple nasal endoscopic surgery, 33 were combined modified Caldwell-Luc procedure with nasal endoscopic surgery, and 3 combined lateral rhinotomy with endoscopic surgery. All these patients were followed up for 6 to 12 years post-operatively. Results All patients were histopathologically confirmed with the lesion of nasosinous inverting papilloma postoperatively, with malignant transformation in 5 cases among them. As shown from following up results, all were cured other than 14 cases with their lesions reoccurred （12.06%）. In the reoccurred cases, 5 were seen with the lesion at grade ]1 （5/62, 8.06%）, 8 were at grade m （8/27, 29.63%）, and 1 at gradelV （1/6,16.67%）. Conclusions It should be much reasonable to take an appropriate surgical strategy to treat such a kind of lesion according to its primary localization and invassive content. Then, the curative rate can be improved and reoccurring rate may be reduced.