7例鼻中隔恶性肿瘤的临床诊治分析

Diagnosis and treatment of nasal septum malignancy:a clinical analysis of seven cases

目的：探讨鼻中隔恶性肿瘤的临床诊断与治疗方法。方法：收集1993年2月至2009年10月天津市第一中心医院收治7例原发于鼻中隔的恶性肿瘤患者的临床资料,分别采用鼻内镜或鼻外径路或唇正中切口面部翻揭手术加放疗或化疗,并对生存状况进行回顾性分析。结果：恶性淋巴瘤1例经病理证实术后予化疗和放疗,其余6例包括腺样囊性癌3例、恶性黑色素瘤1例、软骨肉瘤1例、乳头状瘤恶变1例。随访2~16年,2例分别于术后2年及3年4个月因复发或转移而死亡,其余5例生存、未见肿瘤复发。结论：对于原发于鼻中隔的恶性肿瘤以手术切除为主（恶性淋巴瘤除外）,关键是一次性彻底切除,术后应采取放化疗等综合治疗,并予严密随访。

Objective： To explore the clinical diagnosis and treatment methods for nasal septum malignancies. Methods： A retrospective study of seven cases of primary nasal scptum malignancy was conducted. These cases were treated at the Tianjin First Central Hospital between February 1993 and October 2009. Results： Among the seven cases, one was reported malignant lymphoma, which underwent chemotherapy and radiation therapy; the other six malignant tumors included three cases of adenoid cystic carcinoma, one malignant melanoma, one chondrosarcoma, and one papilloma. Patients were treated by nasal endoscopy, extemal approach, lip midline incision, overturned facial surgery, chemotherapy, and radiation. During follow-up, which lasted for 2 years to 16 years from time of surgery, two fatalities resulting from recurrence or metastasis were recorded. One of these fatalities occurred after 2 years, and the other was recorded at 3 years and 4 months after surgery. Four patients survived without recurrence. Conclusion： The key treatment for nasal septum malignancies was one-time radical resection. Combined postoperative treatment and follow-up should be conducted.