三种复发性喉乳头状瘤治疗方法的疗效分析

目的探讨复发性喉乳头状瘤的有效治疗方法。方法回顾性分析我院2000年1月～2005年12月诊治的67例复发性喉乳头状瘤患者的临床资料。结果67例中未成年患者组47例，占70．1％；成年患者组20例，占29．9％。行喉造口喉乳头状瘤激光切除术34例，16例复发（未成年患者13例，成年患者3例），占47．1％；术后喉狭窄15例（未成年患者12例，成年患者3例），其中9例为再次复发者。行喉部分切除术3例，随访2年未再复发，且均无喉狭窄出现。行支撑喉镜下喉乳头状瘤CO：激光切除术30例，复发7例，占23．3％；术后喉狭窄6例（均为未成年患者）。术后复发23例中，未成年患者20例占87．0％；成年患者复发3例占13．0％。不同术式的术后复发率及喉狭窄发生率差别有统计学意义（均P〈0．05）；不同年龄组的术后复发率及喉狭窄发生率虽有差异，但无显著意义（P〉0．05）。结论支撑喉镜下喉乳头状瘤CO2激光切除术及术后定期复查是目前较为有效的治疗复发性喉乳头状瘤的方法。

Surgical Treatment of Recurrent Respiratory Papillomatosis

Objective To review our experience in the management of recurrent respiratory,papillomatosis (RRP) at our Department of Otorhino- laryngology. Methods We retrospectively reviewed our medical records of all patients diagnosed with recurrent respiratory papillomatosis between Jan 2000 to Dec 2005. Results A total of 67 patients (47 children,20 adults) received surgical treatment and 23(20 children,3 adults) recurred.Thirty four patients underwent laryngeal stomal laser excision of RRP and 16(13 children,3 adults) recurred (47.1%),stenosis occurred in 15 cases(12 children,3 adults).Malignant transformation was detected in three patients with adult type of recurrent respiratory papil- lomatosis and the partial laryngectomy was performed.Thirty patients underwent carbon dioxide laser excision with microlaryngoscope and 7 recurred (23.3%),stenosis occurred in 6 children.The interval between surgical procedures was between 2 months to 3 years. Conclusions The carbon dioxide laser excision with mierolaryngoscope is better in recurrent and trauma rates.The carbon dioxide la- ser is the preferred method for surgical removal of RRP and it is very helpful to recheck periodically.