复发性上颌窦内翻性乳头状瘤二次手术探讨

目的：探讨复发性上颌窦内翻性乳头状瘤二次手术治疗策略。方法回顾性分析32例复发性上颌窦内翻性乳头状瘤的临床资料，包括复发并恶变7例。鼻内镜下手术28例，泪前隐窝入路9例，上颌窦内侧壁切除入路13例，扩大上颌窦内侧壁切除入路6例，上颌骨切除术4例。总结疗效，分析其手术治疗策略。结果术后随访13～39个月，治愈29例；复发3例，其中2例经再次手术治愈；死亡1例。结论对于本病，应根据病变侵犯范围合理选择二次手术的手术入路及手术范围，以彻底切除病灶。内镜下多种手术入路可达切除肿瘤目的，可以避免鼻外辅助切口。

Reoperation for recurrent inverting papilloma in maxillary sinus

Objective TTo explore the therapeutic strategy with reoperation on cases with recurrent inverting papilloma in maxillary sinus.Methods A retrospective study was carried out among 32 cases with recurrent inverting papilloma in maxillary sinus, including 7 of relapse accompanied simultaneously with the lesion malignantly transformed, with their clinical data carefully analyzed. All these cases were given surgical treatment again, with 28 cases operated on under nasal endoscope, 9 undergoing the approach via anterior lacrimal recess, 13 via the approach of paries medialis maxillaries resection, 6 via that of enlarged paries medialis maxillaries resection, and 4 via maxillectomy.Results By the end of following up period lasted for 13 to 39 months, 29 cases were cured, and 3 cases with lesion reoccurred once more, among whom 2 were cured via surgery again and 1 died.Conclusions It should be important that to carrying out reoperation for cases with recurrent inverting papilloma in maxillary sinus via a reasonable choice of surgical approach based on the invaded extension of lesion in order to achieve the aim of complete resection of involved tissues. A variety of surgical approach under nasal endoscope can achieve the purpose of tumor resection, with the advantage to avoid doing auxiliary incision from the outside of nose as well.