147例鼻内翻性乳头状瘤临床分析

Clinical analysis of 147 cases of inverted papilloma of nose

目的:探讨不同分期的鼻内翻性乳头状瘤手术方式选择策略。方法:对耳鼻咽喉头颈外科147例鼻内翻性乳头状瘤患者的临床资料进行回顾性分析,根据其病变部位、程度、范围进行Kouse分期,分析所选择的手术方式与术后复发率的关系。结果:147例患者中,男89例,女58例,平均46岁,术后随访时间均大于6个月。其中选择单纯性鼻内窥镜下手术者123例,复发率12.19%(15/123):Ⅰ期6例,Ⅱ期7例,Ⅲ期2例;选择鼻内窥镜联合改良柯-陆术式者21例,复发率9.52%(2/21):Ⅲ、Ⅳ期各1例;选择鼻内窥镜联合鼻侧切开术者3例,复发率33.33%(1/3),为Ⅳ期患者。结论:鼻内翻性乳头状瘤是鼻腔、鼻窦较常见的良性肿瘤,手术是该病目前首选的治疗方式。Ⅰ~Ⅱ期鼻内翻性乳头状瘤可考虑单纯性鼻内窥镜下手术,Ⅲ期考虑鼻内窥镜联合改良柯-陆术式,Ⅳ期应选择鼻内窥镜联合鼻侧切开手术。

Objective To explore the surgical strategies for different stages of nasal inverted papilloma. Method 147 cases of nasal inverted papilloma patients were retrospectively analyzed and graded according to Krouse Standerd classification. To think about the relationship between surgical mode and recurrence rate. Results Of the 147 patients,89 were malec and 58 females,with an average age of 46 years. All patients were followed up for more than 6 months. All cases＇ postoperative follow-up time all more than six months. 123 patients for simple nasal endoscopic surgical,the recurrence rate was 12. 19%（ 15/123） ： 6 cases for level Ⅰ,7 cases for level Ⅱ,2 for stage Ⅲ; 21 cases for Nasal endoscopic combined C-L operation,the recurrence rate was9. 52%（ 2/21） ： Each level Ⅲ and Ⅳ had 1 case; 3 cases for nasal endoscopic joint nasal lateral incision,the recurrence rate was 33. 33%（ 1/3）,all in level Ⅳ. Conclusion Nasal inverted papilloma is a common benign tumor in nasal cavity and sinuses,surgery is the primary treatment at present. Stage Ⅰ ~ Ⅱ can consider simple nasal endoscopic surgery,stage Ⅲ should consider nasal endoscopic combined C-L operation,stage Ⅳ should choose nasal endoscopic joint nasal lateral incision surgery.