鼻腔及鼻窦内翻性乳头状瘤不同手术方式的选择

Diagnosis and Treatment of Sinonasal Inverted Papillom

目的探讨鼻腔及鼻窦内翻性乳头状瘤手术方式的选择。方法 2005年10月-2012年9月104例鼻腔及鼻窦内翻性乳头状瘤根据病变范围和分期情况,分别采用中鼻道径路鼻内镜手术、联合尖牙窝径路鼻内镜手术及联合柯陆径路鼻内镜手术3种手术方法。结果中鼻道径路鼻内镜手术时间（68±8）min,出血量（93±17）ml;联合尖牙窝径路手术时间（89±19）min,出血量（162±28）ml;联合柯陆径路手术时间（112±18）min,出血量（206±36）ml。3种术式术中均彻底切除肿瘤,无并发症发生。104例术后随访16-36个月,平均24个月,中鼻道径路复发4例,联合尖牙窝径路复发2例,联合柯陆径路复发2例,总复发率7.7%（8/104）。结论鼻内镜手术是治疗鼻腔及鼻窦内翻性乳头状瘤安全、有效的方法。

Objective To discuss the choice of operation method for nasal inverted papilloma（ NIP）. Methods From October 2005 to September 2012,there were 104 cases of NIP. According to the scope of the lesions and staging,the operational nasal passages were middle nasal canal approach endoscopic surgery,canine fossa approach nasal endoscopic surgery,and Caldwell-Luc approach nasal endoscopic surgery. Results For middle nasal canal approach endoscopic surgery,the operation time and blood loss were（ 68 ± 8） min and（ 93 ± 17） ml. For canine fossa approach nasal endoscopic surgery,the operation time and blood loss were（ 89 ± 19） min and（ 162 ± 28） ml. For Caldwell-Luc approach nasal endoscopic surgery,the operation time and blood loss were（ 112 ± 18） min and（ 206 ± 36） ml. All the tumors were resected completely by using the three kinds of operation methods without complications. Postoperative follow-ups in the 104 cases for 16- 36 months（ mean,24 months） found 4 cases of recurrence for middle nasal canal approach endoscopic surgery,2 cases of recurrence for canine fossa approach nasal endoscopic surgery,and 2 cases of recurrence for Caldwell-Luc approach nasal endoscopic surgery,the overall recurrence rate being 7. 7%（ 8 /104）. Conclusion Nasal endoscopic surgery in the treatment of NIP is safe and effective.