蝶窦内翻性乳头状瘤2例并文献分析

Inverted papilloma of the sphenoid sinus: case report and systematic review of the literature

目的探讨蝶窦内翻性乳头状瘤的临床特点、诊断及治疗方法。方法报告2016年5月我科收治的原发于蝶窦的内翻性乳头状瘤患者2例,同过应用CNKI、VIP、万方、Pub Med等中英文数据库检索2000~2017年蝶窦乳头状瘤的相关文献,共计获得14篇文献43例蝶窦内翻性乳头状瘤患者的资料。结果本文2例患者均行手术治疗,术后病理提示蝶窦内翻性乳头状瘤,其中1例为乳头状瘤恶变。将该例患者与既往报道的41例蝶窦内翻性乳头状瘤患者合并分析,结果显示:病患者发病年龄平均为58.1岁,其中最多男性病例的病例数占大多数,蝶窦内翻性乳头状瘤的临床症状主要有鼻塞、流脓涕带血,偶有头痛和嗅觉异常、视力异常、听力异常,所有患者均以手术治疗。结论蝶窦内翻性乳头状瘤临床罕见,表现不典型,早期易误诊,漏诊,诊断需要靠病理检查,唯一的治疗方法是手术治疗,预后良好。

Objective To explore the clinical features,diagnosis and treatment of the inverted papilloma of the sphenoid sinus.Methods Two patients who were reported as inverted papilloma of the sphenoid sinus(May,2017)was treated in our hospital.The related literatures about inverted papilloma of the sphenoid sinus from 2000 to 2017 were retrieved by CNKI,VIP,Wanfang and PubMed databases.Total 43 cases of IP of the sphenoid sinus patients were obtained from 14 papers.Results After treated with surgery,2 postoperative pathological results were inverted papilloma of the sphenoid sinus,but one was cancerization.41 patients with inverted papilloma of sphenoid sinus reported in the past were analyzed.The results displayed that the average age of onset was 58.1 years old,and most of the cases were male.The main clinical symptoms of inverted papilloma of sphenoid sinus were nasal obstruction,bloody pus,occasional headache,olfactory abnormalities,visual abnormalities and hearing abnormalities,and all patients were treated by surgery.Conclusion Inverted papilloma of the sphenoid sinus is rare and easy to be misdiagnosed and missed in early stage.The diagnosis depends on pathological examination.The unique treatment is surgery but the prognosis is favourable.