外鼻肿物34例临床分析  

Clinical analysis of 34 cases of external nasal mass

作　　者：史雅文[1] 汪李琴 殷敏[1] SHI Yawen;WANG Liqin;YIN Min(Department of Otorhinolaryngology,the First Affiliated Hospital,Nanjing Medical University,Nanjing 210029,China)

机构地区：[1]南京医科大学第一附属医院耳鼻咽喉科,江苏南京210029

出　　处：《中国耳鼻咽喉颅底外科杂志》2024年第5期12-17,共6页Chinese Journal of Otorhinolaryngology-skull Base Surgery

基　　金：北京白求恩公益基金会“白求恩·医学科学研究基金项目2023年第006号基金支持课题”(2023YWZJ006-ym)。

摘　　要：目的探讨外鼻肿物的临床流行病学特点,分析切除后缺损的修复方法及临床效果。方法回顾性分析2010年1月-2020年12月收治的34例外鼻肿物,分析肿物的发病部位、大小、病理类型、手术和修复方法等。结果本组患者,男女发病比例为1.125∶1,男女发病率差异无统计学意义(P>0.05);外鼻恶性肿瘤中,基底细胞癌最多(16例,80%),各年龄层均有发病,恶性肿瘤的发病高峰年龄为60岁以上人群(15例,75%)。术中彻底切除肿物后,选择直接缝合15例,邻近皮瓣修复7例,转移鼻唇沟皮瓣修复10例,植皮2例。术后随访1例接受放化疗,2例接受单纯化疗。28例伤口一期愈合,鼻外观基本对称,鼻腔无明显通气功能障碍。1例行二期瘢痕修复。3例失访,3例死亡(死于老龄),2例对外鼻形态不满意。结论外鼻肿物切除彻底,很少复发,一般无需放化疗。在手术彻底切除肿瘤的基础上,依据缺损部位及程度灵活应用不同的修复方法,重建鼻部轮廓,保持鼻部外形及结构的完整性。其中鼻唇沟皮瓣修复操作方便,并发症少,患者取得满意效果,是临床常选择的治疗方案。Objective To investigate the clinical epidemiological characteristics of external nasal mass,and analyze the repair methods and clinical effects of resected defects.Methods Clinical data of 34 patients with external nasal mass treated in our hospital from January 2010 to December 2020 were analyzed retrospectively.The analyzed data included location,size and pathological diagnosis of tumors,surgical and repair methods.Results Of all the 34 cases,the ratio of male to female was 1.125∶1,and the difference was statistically insignificant(P>0.05).Among the external nasal malignancies,basal cell carcinoma was the most common(16 cases,80%),and occurred in all age groups.The peak age of malignant tumors was the elderly population over 60 years old(15 cases,75%).After complete resection,15 cases were sutured directly,7 cases were repaired with adjacent flap,10 cases were repaired with nasolabial sulcus flap,and 2 cases were grafted with skin.During postoperative follow-up,1 case received chemoradiotherapy and 2 received chemotherapy alone.Primary wound healing was achieved in 28 cases with basically symmetrical appearance and without obvious ventilation dysfunction.Second stage scar repair was performed in one case.Three cases were lost to follow-up,three died(due to old age),and two had unsatisfactory external nasal morphology.Conclusions The external nasal masses rarely recur after complete resection,and chemoradiotherapy is generally not required.On the basis of complete resection of the tumor,different repair methods can be flexibly applied according to the defect site and degree to reconstruct the nasal contour and maintain the integrity of the nasal shape and structure.The nasolabial sulcus flap is a common choice of treatment because of its convenient operation,few complications and satisfactory results.

关 键 词：外鼻肿物 缺损 鼻唇沟皮瓣 修复 

分 类 号：R765.1[医药卫生—耳鼻咽喉科]