鼻内镜下鼻-鼻窦内翻性乳头状瘤手术疗效分析

目的 评价鼻内镜下各种手术方法治疗鼻-鼻窦内翻性乳头状瘤(IP)的效果.方法 回顾性分析58例有完整随访资料的经鼻内镜手术治疗的鼻-鼻窦IP患者,统计分析不同患者类型、Krouse分期或手术方法的复发率.结果 随访(68±3)个月,6例术后复发.其中初发和复发患者的复发率分别为9.8%(4/41)、11.8%(2,17);Krouse分期Ⅰ期、Ⅱ期、Ⅲ期和Ⅳ期患者的复发率分别为11.1%(1,9)、6.7%(2,30)、6.7%(1/15)和50.0%(2/4);单纯鼻内镜、鼻内镜辅助柯一陆手术进路术与鼻内镜辅助鼻侧切开进路术复发率分别为15.6%(5/32)、4.2%(1/24)和O(O/2).不同患者类型、Krouse分期或手术方法的复发率比较差异均无统计学意义(均P＞0.05).结论 经鼻内镜手术治疗鼻-鼻窦IP安全、有效、微创,根据不同患者类型以及分期采用不同的内镜手术方法是治疗成功的关键.

Efficacy analysis of endoscopic surgery for sinonasal inverted papilloma

Objective To evaluate the efficacy of various nasal endoscopic surgery for sinonasal inverted papilloma (SIP).Methods Complete follow-up data of 58 cases of sinonasal inverted papilloma were retrospectively analyzed.Patient types as well as Krouse staging and rates of recurrence with various surgery were statistically analyzed.Results During the follow-up for (68±3) months, SIP recurred in 6 cases.The rate of recurrence was 9.8% (4/41) in cases with primary diagnosis vs 11.8% (2/17) in those with relapsing tumors, respectively.Recurrence rates with stages Ⅰ , Ⅱ , Ⅲ and Ⅳ tumors were 11.1% (1/9),6.7% (2/30), 6.7% (1/15) and 50.0% (2/4) respectively.For simple nasal endoscopic surgery, endoscopyassisted Caldwell-Luc's surgery, and endoscopy-assisted lateral rhinotomy, the recurrence rates were 15.6% (5/32) , 4.2% (1/24) and 0 (0/2), respectively.There was no significant difference among patient types,Krouse staging or surgical methods.Conclusions Nasal endoscopic surgery is a safe, effective and minimally invasive method for sinonasal inverted papilloma.Selection of endoscopic surgery according to patient type and stage is critical for a successful treatment.