鼻内翻性乳头状瘤手术进路选择  

Different options for surgical approach of nasal inverted papilloma

作　　者：徐海峰[1] 陶泽璋[1] 孔勇刚[1] 黄小林[2] 许昱[1] 梅志丹[1] 

机构地区：[1]武汉大学人民医院耳鼻咽喉头颈外科,湖北武汉430060 [2]武汉大学鄂州中心医院耳鼻咽喉科,湖北鄂州436000

出　　处：《中国耳鼻咽喉头颈外科》2005年第8期515-517,共3页Chinese Archives of Otolaryngology-Head and Neck Surgery

摘　　要：目的探讨不同手术进路切除鼻内翻性乳头状瘤的适应证。方法对35例(39侧)鼻内翻性乳头状瘤患者术前行鼻窦CT扫描和鼻内镜检查,根据肿瘤部位和范围分别采取鼻侧切开术9例(9侧),鼻内镜下经鼻进路20例(22侧),面正中掀翻进路2例(4侧)和经鼻内外联合进路术式4例(4侧)。术后随访23个月～11年,平均37个月。结果9侧行鼻侧切开术中1侧复发(11%),22侧鼻内镜下经鼻进路中2侧复发(9%),其它进路无复发病例。结论应根据肿瘤原发部位和范围选择相应的术式。局限于筛窦、蝶窦、上颌窦窦口周围以及额隐窝周围的肿瘤可采取鼻内镜下经鼻进路手术。OBJECTIVE To explore the indications for surgical approach of nasal inverted papilloma based on clinical data. METHODS In a retrospective study, clinical date of 35 patients （39 sides） were treated surgically in the ENT department of People＇s Hospital of Wuhan university from 1992 to 2002. A preoperative CT scan was performed in all cases. All patients were examined by endonasal endoscopy prior to surgery. Based on the extensions and sites of the lesions, endonasal excision of the papilloma was carried out, on 20 patients （22 sides） and on 11 patients （13 sides） rhinotomy or face uncover approach were performed. A combined endonasal and external approach was applied on 4 patients （4 sides）. Patients were followed up and endoscopically examined until november 2002. RESULTS Recurrence rate was 9% （2 out of 22 sides） after tumor resection endonasally; 11% （1 out of 9 sides） after rhinotoing. CONCLUSION Based on the extensions and sites of the lesions, we should have different approaches to different cases. The endonasal microsurgial approach should be preferred to the cases with tumours localized in the ethmoid, sphenoid, maxillary sinus and frontal sinus ostium.

关 键 词：鼻肿瘤 乳头状瘤 内翻 外科手术 内窥镜检查 鼻内翻性乳头状瘤 手术进路选择 鼻侧切开术 鼻窦CT扫描 肿瘤部位 

分 类 号：R739.6[医药卫生—肿瘤]