鼻内翻性乳头状瘤的手术方式选择  

Different surgery approaches for nasal inverted papilloma

作　　者：赵新[1] 肖大江[1] 

机构地区：[1]南京医科大学附属无锡二院耳鼻喉科,江苏无锡214002

出　　处：《海南医学院学报》2010年第7期909-911,共3页Journal of Hainan Medical University

基　　金：海南医学院科研基金资助学报项目(0020100256)~~

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78例鼻内翻性乳头状瘤患者术前行鼻窦CT、MRI和鼻内镜检查,进行Krouse分期,分别予鼻侧切开术、单纯鼻内镜手术、经鼻内镜联合上颌窦根治术,术后随访15个月～11年,平均36个月。结果:鼻侧切开术33例,术后复发6例(18.2%);单纯鼻内镜手术组26例,复发2例(7.6%);经鼻内镜联合上颌窦根治术进路19例,复发3例(15.8%)。单纯鼻内镜手术及鼻内镜联合鼻外进路组术后平均复发率为11.1%,明显低于鼻侧切开组(P<0.05)。结论:应依据肿瘤原发部位和范围选择相应的术式。Krouse分期I～III期患者,可采用单纯鼻内镜或经鼻内镜联合上颌窦根治术进路,Krouse分期IV期患者还是采用鼻侧切开较稳妥。Objective：To discuss indications of nasal inverted papilloma for surgical treatments by different approaches.Methods：Krouse scores of 78 nasal inverted papilloma cases were evaluated based on CT,MRI scan,or endonasal endoscopy examination.Rhinotomy,simple endonasal endoscopic surgery,combined endonasal endoscopy and radical maxillary sinusotomy were sperately performed on these patients.An average of 36 months＇ follow-up ranging from 15 months to 11 years was conducted.Results：Follow up showed that recurrence rate was 18.2%（6/33）、7.6%（2/26）、15.8%（3/19）for those underwent rhinotomy,simple endonasal endoscopic surgery,and combined endonasal endoscopy and radical maxillary sinusotomy;the average recurrence rate of the latter two surgery methods was 11.1%,significant lower than that of the rhinotomy（P〈0.05）.Conclusions：Different approaches should be applied on primary lesions,for Krouse IIII stage patients,simple endonasal endoscopic surgery,or combined endonasal endoscopy and radical maxillary sinusotomy is proper;while for Krouse stage IV patients,rhinotomy is safer.

关 键 词：鼻肿瘤 内翻性乳头状瘤 鼻内镜 

分 类 号：R739.62[医药卫生—肿瘤]