鼻内镜手术治疗鼻咽癌放疗后鼻窦炎

目的 探讨以鼻内镜鼻窦手术为主的综合治疗对鼻咽癌放射治疗后鼻窦炎的疗效.方法 对我科2004年9月至2007年9月收治的经病理确诊的98例鼻咽癌放射治疗后鼻窦炎患者,行鼻内镜手术为主的综合治疗.手术在放疗后6个月至9年进行.随访12～34个月,观察其疗效.结果 治愈56例(57.1%),好转33例(33.7%),无效9例(9.2%),总有效率(包括治愈和好转例数)为90.8%.随访期间无鼻咽癌复发.结论 鼻内镜鼻窦手术是治疗鼻咽癌放疗后鼻窦炎的有效方法,术中严格控制创伤范围,保留可用黏膜,术后恰当的综合处理是提高疗效的关键.

Effect of endoscopic surgery on irradiation-induced rhinosinusitis in patients with nasopharyngeal carcinoma

Objective To investigate the effect of endoscopic sinus surgery combined with other adjunctive the-rapy on irradiation-induced rhinosinusitis in patients with nasopharyngeal carcinoma(NPC). Methods Ninety-eight NPC patients with irradiation-induced sinusitis hospitalized from September 2004 to September 2007 were enrolled in the study. All patients were treated with endoscopic surgery combined with other adjunctive therapy and followed up for 12 to 34 months. The surgery was performed 6 months to 9 years after the irradiation therapy. Results Fifty-six cases (57.1%) were completely cured, 33 cases (33.7%) were improved and 9 cases (9.2%) were ineffective. The total effective rate (including the cured and improved cases) was 90. 8%. No recurrence was observed. Conclusions Endoscopic sinus surgery was an effective method in the treatment of irradiation-induced rhinosinusitis in patients with nasopharyngeal car-cinoma. The key points to enhance the curative effect included strict control of wound during the surgery, the reservation of the useful mucosa and appropriate postoperative therapy. (Chin J Ophthslmol and Otothinolaryngol ,2009,9:236-237)