鼻内镜或鼻内镜辅助下手术切除复发性鼻腔鼻窦内翻性乳头状瘤  

Endoscopic or endoscopic-assisted surgery for recurrent sinonasal inverted papilloma

作　　者：古庆家[1] 李静娴[1] 樊建刚[1] 李德炳[1] 何刚[1] 赵李冰[1] 宋林红[2] 

机构地区：[1]四川省人民医院耳鼻咽喉科,成都610072 [2]四川省人民医院病理科

出　　处：《临床耳鼻咽喉头颈外科杂志》2015年第20期1815-1817,共3页Journal of Clinical Otorhinolaryngology Head And Neck Surgery

摘　　要：目的：探讨鼻内镜下或鼻内镜辅助下手术治疗复发性鼻腔鼻窦内翻性乳头状瘤（SIP）的疗效。方法：回顾性分析28例复发性SIP患者的临床资料。全部患者既往均有鼻腔鼻窦手术史,其中复发1次者17例,复发2次者10例,复发3次者1例。全部患者均接受鼻内镜或鼻内镜辅助下手术。结果：随访2~6年,仅3例在手术后复发,其余25例在随访期内均未见复发。5例患者术后发现鳞状细胞癌或灶性恶变,接受放疗并随访至今,1例复发2次并再次行手术治疗,2例死亡,2例未见复发。结论：鼻内镜下或鼻内镜辅助下手术是治疗SIP的首选方法,优势在于创伤小、并发症少和有利于保护鼻腔功能。对于有恶变者采取术后放化疗综合治疗,可提高长期生存率。彻底切除肿瘤和术后定期随访是治疗成功的关键。Objective： To investigate the therapeutic effect of nasal endoscopic and endoscopic-assisted surgery in the management of recurrent sinonasal inverted papilloma（SIP）. Method：The clinical data of 28 patients treated with endoscopic surgery were retrospectively analyzed. All the patients had the history of endoscopic sinus surgery,17 patients recurred once,10 recurred twice and 1 recurred 3 times. Result：All patients were followed up from 2 to 6 years. Among them,25 cases with tumor totally removed had no recurrence, whereas three cases re- curred during the follow-up period. Five cases with squamous cell carcinoma or focal eanceration were given radio- therapy after surgery. Except two patients died of recurrence, 1 received operation again after relapsed twice and the other two patients were alive without recurrence. Conclusion： The complete and positive surgical treatment is the preferred method for the management of SIP. Optimal treatment options should be selected according to the lo- cation of origin and associated malignancy. Comprehensive treatment for malignant transformation is adopted to improve the cure rate and reduce the recurrence rate. And postoperative nasal endoscopic examination , nasal CT scan and long-term follow up are the key points for success.

关 键 词：乳头状瘤 内翻 鼻腔 鼻窦 内镜外科手术 

分 类 号：R739.62[医药卫生—肿瘤]