60例鼻前庭肿块的临床分析

目的　总结鼻前庭肿块的临床诊治经验。方法　回顾性分析 1982年 5月～ 2 0 0 3年4月收治的 6 0例鼻前庭肿块患者的临床资料、手术方法及径路。结果　 6 0例鼻前庭肿块中良性肿瘤5 1例 ,炎性疾病 5例 ,恶性肿瘤 4例 ,均行手术治疗 ,术后无并发症 ,痊愈出院。 5 1例良性肿瘤和 5例炎性肿块患者中 ,37例随访 5个月～ 15年 (平均 97个月 )无复发和恶性变 ;2例复发再次手术治疗 ;6例死于其他疾病 ;11例失访。 4例恶性肿瘤患者中 ,2例恶性黑色素瘤分别于术后 1年、4年 10个月复发 ,再次行鼻侧切开肿瘤切除 ,分别于第 2次术后 1年 3个月和 6年 10个月死于复发和肝转移 ;乳头状瘤癌变和非霍奇金淋巴瘤患者已无瘤生存超过 17年和 5年 2个月。结论　鼻前庭解剖区域虽小 ,但各种性质的肿块均可发生 ,治疗以手术切除为主 ,手术途径根据肿块的位置、大小及性质而定。

Analysis of 60 masses in the nasal vestibule

Objective To summarize the treatment strategy of nasal vestibule masses. Methods Between May, 1982 and April,2003,60 patients with nasal vestibule mass were treated in our department. The clinical features of these masses were retrospectively analysed. Results Among 60 masses, 51 cases were benign tumors, 5 cases were inflammatory masses, and 4 cases were malignant tumors. All patients were surgically treated and discharged with complete recovery. Among patients with benign tumor and non-specific inflammatory mass, 37 patients with a median follow-up of 97 months without recurrence and malignant change. One patient with hidradenoma and one patient with rhinoscleroma recurred and another surgery was carried out. There was no recurrence after second surgery. 6 patients died of other diseases, and 11 patients lost follow-up. Two patients with malignant melanoma recurred after first surgery. Then the tumor was removed via lateral rhinotomy and died of local recurrence and liver metastasis. Two patients (one with papilloma carcinomatous change and another with non-Hodgkin lymphoma) were free of diseases 17 years or 5 years and 2 months respectively. Conclusions Masses of different histological types can be found in the nasal vestibule. Surgical removal is the treatment of choice. The approaches are determined on the basis of site, size and kind of the masses.