鼻内镜手术治疗鼻乳头状瘤临床资料分析  

Analysis of clinical data of endoscopic surgery for nasal papilloma

作　　者：季俊峰[1] 刘厚军 焦红叶 陈伟[1] 张勇[1] 王志颐 许莉[1] 程友[1] JI Junfeng;LIU Houjun;JIAO Hongye;CHEN Wei;ZHANG Yong;WANG Zhiyi;XU Li;CHENG You(Department of Otolaryngology Head and Neck Surgery,General Hospital of Eastern Theater Command,PLA,Nanjing,Jiangsu,210002,China)

机构地区：[1]东部战区总医院(原南京军区南京总医院)耳鼻咽喉头颈外科,江苏南京210002

出　　处：《中国耳鼻咽喉头颈外科》2021年第5期297-300,共4页Chinese Archives of Otolaryngology-Head and Neck Surgery

基　　金：全军“十二五”面上项目(CNJ13J006)。

摘　　要：目的分析鼻内镜手术治疗鼻乳头状瘤的方法及疗效。方法回顾性分析2011年1月2018年12月123例住院鼻内镜手术的鼻乳头状瘤临床资料。根据病变程度和范围,选择经典鼻内镜手术、鼻内镜中下鼻道联合开窗术、鼻内镜辅助下Caldwell-Luc手术、鼻内镜下泪前隐窝入路手术、Draf手术以及鼻内镜下辅助鼻侧切开术等术式。分析术后病理分型比例,病变累及部位、范围、术后复发率。结果随访28年,中位随访时间29个月。病理分型比例为外翻性乳头状瘤32.5%(40例)、内翻性乳头状瘤61.8%(76例)、嗜酸性细胞乳头状瘤5.7%(7例)。外翻性乳头状瘤未见复发病例,内翻性乳头状瘤复发率为13.2%(10例)、嗜酸性细胞乳头状瘤复发率为14.3%(1例)。结论针对鼻乳头状瘤的不同病理类型、病变范围、病变累及的部位,采用合适的鼻内镜下手术进路和方式,结合术后密切随访处理,能安全有效的切除病灶,降低复发率。OBJECTIVE To analyze the method and effect of endoscopic nasal surgery for nasal papilloma.METHODS Clinical data of 123 cases of nasal papilloma undergoing endoscopic surgery from January 2011 to December 2018 were retrospectively analyzed.According to the degree and scope of the lesion,classic nasal endoscopic surgery,endoscopic inferior nasal meatus fenestration combined with middle nasal meatus fenestration,endoscope-assisted Caldwell-Luc surgery,endoscopic prelacrimal recess approach,Darf surgery,and endoscopic assisted lateral rhinotomy were selected.The proportion of postoperative pathological classification,site and scope of lesion involvement,postoperative recurrence rate were analyzed.RESULTS All cases were followed up for2-8 years,with a median follow-up of 29 months.The pathological classification was 32.5%(40 cases) of exophytic papilloma,61.8%(76 cases) of inverted papilloma,and 5.7%(7 cases) of oncocytic schniderian papilloma.The recurrence rate was 0%(0 case) of exophytic papilloma,13.2%(10 cases) of inverted papilloma and 14.3%(1 case) of oncocytic schniderian papilloma.CONCLUTION According to the different pathological types,lesion range and sites of the nasal papilloma,the tumor can be removed safely and effectively by appropriate approach and method of endoscopic surgery combined with strict postoperative follow-up,and the recurrence rate can be also reduced.

关 键 词：内窥镜检查 乳头状瘤 嗜酸细胞 

分 类 号：R739.62[医药卫生—肿瘤]