鼻腔鼻窦内翻性乳头状瘤不同术式的疗效比较

Comparison on therapeutic effects of different surgical procedures on nasal inverted papilloma

关键词:  鼻肿瘤  内翻性乳头状瘤  内窥镜检查  手术治疗

Key words:  nose neoplasms  nasal inverted papilloma  endoscopy  surgical therapy

摘要:

［目的］比较不同术式治疗各级鼻腔鼻窦内翻性乳头状瘤的复发率，对术式的选择进行探讨。［方法］对大连医科大学附属第一医院耳鼻咽喉科1997年11月~2006年12月共77例手术治疗鼻腔鼻窦内翻性乳头状瘤的患者（术后病理证实为鼻腔鼻窦内翻性乳头状瘤）进行统计分析和随访调查，根据Krouse分级系统将肿瘤分为4级，并对所有患者术后情况进行随访。［结果］术后平均随访4.82年显示肿瘤复发率：经鼻内镜手术者1例（9.1%）； 经鼻侧切开手术者2例（4.2%）；经柯一陆手术者2例（28.6%）；经传统的鼻内入路手术者2例（66.7%）；经鼻内镜联合柯一陆手术者1例（12.5%）。经鼻内镜手术组与经鼻侧切手术组间差异无统计学意义（P＞0.05）。［结论］对单侧鼻腔鼻窦肿物，应警惕内翻性乳头状瘤发生的可能，术前务必取活检明确病理诊断。再根据Krouse分级选择合适的术式。

Abstract:

［Objective］To compare the recurrence ratio of different surgical procedures on nasal inverted papilloma.［Methods］According to Krouse classification, 77 patients with nasal inverted papilloma treated surgically were retrospectively reviewed form November 1997 to December 2006.［Results］With an average follow-up of 4.82 years, the recurrence ratio for endoscopic group was 9.1% (1/11); The recurrence ratio for lateral rhinotomy group was 4.2% (2/48); The recurrence ratio for Caldwell-Luc procedure group was 28.6% (2/7); The recurrence ratio for intranasal approach group was 66.7% (2/3); The recurrence ratio for endoscopic excision combined with Caldwell-Luc procedure group was 12.5% (1/8). There is not statistical significance between endoscopic group and lateral rhinotomy group (P＞0.05).［Conclusions］To unilateral nose neoplasms, we must pay attention to the possibility of nasal inverted papilloma, and the pathological diagnosis must be determined according to the biopsy before surgery. And select the appropriate surgical procedures according to Krouse classification.