联合鼻内镜手术治疗鼻内翻性乳头状瘤的疗效观察  

Observation of the Effect of Endoscopic Surgery on Nasal Inverted Papilloma

作　　者：杨明明[1] 田兴德[2,3] 强笔[2,3] 孟玲[2,3] 华清泉[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]长江大学临床医学院 [3]荆州市第一人民医院耳鼻咽喉头颈外科,湖北荆州434000

出　　处：《长江大学学报（自科版）（下旬）》2013年第3期5-6,4,共2页Journal of Yangtze University

摘　　要：目的:探讨鼻内镜手术联合平阳霉素局部注射在鼻内翻性乳头状瘤(nasal inverted papilloma)手术中的疗效。方法:参考Krouse分期法对16例确诊鼻腔鼻窦内翻性乳头状瘤患者进行分期,13例Ⅰ～Ⅱ级病例行经鼻内镜肿瘤切除术+平阳霉素局部注射,2例Ⅲ级病例行鼻内镜手术联合上颌窦根治术,1例Ⅳ级行鼻内镜手术联合鼻外侧进路。结果:手术后术前症状均消失,术中术后无严重并发症,术后病理学检查均证实诊断,随访6～18个月内未见复发。结论:鼻内镜手术+平阳霉素局部注射是治疗Ⅰ～Ⅱ级鼻内翻性乳头状瘤一种较好的方法,对于Ⅲ、Ⅳ级病变者,必要时尚需联合改良的上颌窦根治术。Objective:To study the method and effect of endoscopic surgery for nasal inverted papilloma.Methods:Sixteen patients had been diagnosed as nasal-sinus inverted papilloma.According to Krouse classification system there were 13 grade Ⅰ～Ⅱ cases,2 grade Ⅲ cases and 1 grade Ⅳ cases.All of them received preoperative endoscopy and CT scan.The papillomas were removed under the endoscopic surgery in 13 grade Ⅰ～Ⅱ cases with PYM intratumor injection at the end of the operation.2 grade Ⅲ cases were treated with combination of the endoscopic surgery and the Caldwell-Luc surgery,1 grade Ⅳ case with the lateral nasal incision approach.Results:All of the cases were routinely followed up for 6 to 18 months to make sure that preoperative symptoms disappeared,there were no complications during and after operations and diagnoses were proved by postoperative pathological examination.Conclusion:The endoscopic surgery with PYM intratumor injection at the end of the operation is an effective method for nasal inverted papillomas of grade Ⅰ～Ⅱ.Endoscopic plus Caldwell-Luc surgery will be the better method for tumors invading maxillary sinus.

关 键 词：平阳霉素 鼻内镜手术 鼻内翻性乳头状瘤 

分 类 号：R765[医药卫生—耳鼻咽喉科]