鼻內鏡下手術治療鼻腔鼻竇內翻性乳頭狀瘤

Endoscopic surgery for sinonasal inverted papilloma

目的總結鼻內鏡下治療鼻腔鼻竇內翻性乳頭狀瘤的手術方式及療效。方法對2010年5月~2016年6月18例住院病人的鼻腔鼻竇內翻性乳頭狀瘤患者資料進行回顧性分析。根據病變範圍及分期情况(鼻內鏡檢查及CT),採取標準式鼻內鏡手術、擴大式鼻內鏡手術或鼻內鏡聯合鼻外進路手術,術後隨訪2~25月,並觀察遠期療效。結果術中可達到內鏡直視下切除腫瘤,全部病例無發生嚴重併發症,隨訪統計標準式鼻內鏡手術病例16例,其中復發1例;擴大式鼻內鏡手術1例;聯合進路1例。結論鼻內鏡下手術治療鼻腔鼻竇內翻性乳頭狀瘤是一種安全、有效的方法,根據病變範圍及分期選擇合適的手術方式,並保證腫瘤在明視下切除是我們需要思考的問題。

Objective To study the effects of endoscopic surgery for sinonasal inverted papilloma.Methods A retrospective review of 18 patients with a diagnosis of sinonasal inverted papilloma treated by endoscopic surgery between May 2010 and June 2016 was carried out.Three surgery options as standard endoscopic surgery,extended endoscopic surgery and combining endoscopic surgery with external approaches were performed according to tumor extension assessed preoperatively by endoscopic examination and computer tomography(CT).All patients were followed up for 2~25 months.Results All the lesions could be excised under endoscopy without any complications.There was recurrence in one patient out of standard surgery group(16 cases),one patient received extended surgery group,and one patient received combining surgery group.Conclusion Endoscopic surgery was safe and effective treatment for sinonasal inverted papilloma.Surgical approaches should be carefully selected according to locations and extent of the tumors,and make sure that surgery be performed under endoscopic visual fields.