鼻内镜联合鼻外径路在鼻腔鼻窦内翻性乳头状瘤手术中的应用

目的：探讨鼻内镜联合鼻外径路手术能否降低鼻腔鼻窦内翻性乳头状瘤术后的复发率。方法：将我科2000年1月至2006年1月收治的鼻腔鼻窦内翻性乳头状瘤且随访资料完整的病例分成两个阶段（2000年1月至2003年1月，2003年1月至2006年1月）行回顾性分析：前一阶段多采用单纯鼻内镜下手术，后一阶段根据病变范围多采用鼻内镜联合鼻外径路手术，比较相同 Krouse分级病例两种手术方式术后复发率有无差异。结果：KrouseⅠ、Ⅱ级病例两种手术方式的复发率差异无统计学意义，KrouseⅢ级病例鼻内镜联合鼻外径路手术的复发率低于单纯鼻内镜下手术的复发率。结论：对于KrouseⅢ级的鼻腔鼻窦内翻性乳头状瘤，鼻外径路手术恰能对目前的鼻内镜手术起到很好的补充，鼻内镜联合鼻外径路手术能更彻底地切除肿瘤，减少残留、复发，同时尽可能地减少创伤

Nasal endoscopy united with external approach surgery for sinonasal inverted papilloma

To explore whether endoscopic surgery united with external approach surgery can cut down the recurrence rate of sinonasal inverted papilloma. Methods: A retrospective analysis was performed for 81 cases treated in our department from January 2000 to January 2006. All the cases were divided into two groups according to the stage: the group of the former stage from January 2000 to January 2003 and the group of the later stage from January 2003 to January 2006. Thirty six cases of the former stage were mostly operated with nasal endoscopy, whereas forty five cases of the later stage were selectively operated with nasal endoscopy united with external approach surgery. The recurrence rate of the two groups in the same Krouse grade was compared. Results: There was no difference between the two operating methods in the cases of Krouse Ⅰand Krouse Ⅱ. But in Krouse Ⅲ, the recurrence rate of those underwent nasal endoscopy united with external approach was lower than that of those only underwent nasal endoscopy. Conclusion: For the cases of Krouse Ⅲ, the external approach is a good supplementary for the surgery under nasal endoscope. Be used nasal endoscope united with external approach surgery, the tumor can be excised more thoroughly, so residual and recurrence, as well as impairment can be cut down.