54例经鼻内镜手术治疗鼻内翻性乳头状瘤的临床分析

发布时间：2018-03-02 08:55

本文关键词： 鼻肿瘤乳头状瘤内镜手术　出处：《临床耳鼻咽喉头颈外科杂志》2014年22期 　论文类型：期刊论文

【摘要】：目的:探讨鼻腔鼻窦内翻性乳头状瘤的复发原因,提高对本病的治愈率,强调术后随访中影像学检查的重要性。方法:对54例鼻腔鼻窦内翻性乳头状瘤患者的资料进行临床分析,包括病史、鼻内镜检查、CT检查并按照Krouse确定的分期系统进行分期,并对手术前影像学评估与术中观察进行对比,研究判定肿瘤原发部位的有效指标,疗效评估包括术后定期随访中内镜检查及结合CT检查结果。结果:54例患者中发病部位以筛窦、鼻腔外侧壁发病率高,累及上颌窦,额隐窝复发率高,中鼻甲未见发病,同时伴癌变占1.85%,无异时癌变。结论:复发原因主要与术前误诊为息肉,手术次数与病变部位有关,累及额隐窝,上颌窦前下壁是复发的危险因素,术前准确判定肿瘤原发部位及术中彻底切除是治愈本病的最有效手段。术后鼻内镜复查并结合鼻CT检查是评估复发的有效手段。
[Abstract]:Objective: to investigate the causes of recurrence of inverted papilloma of nasal cavity and paranasal sinuses, and to improve the cure rate of this disease. Methods: the clinical data of 54 patients with inverted papilloma of nasal cavity and paranasal sinuses were analyzed, including history, CT examination and staging according to the staging system determined by Krouse. By comparing the preoperative imaging evaluation with the intraoperative observation, the effective indexes of the primary tumor site were studied and evaluated. The evaluation of curative effect included endoscopic examination and CT examination during the regular follow-up. Results in 54 patients, ethmoid sinus was the site of the disease. The incidence of the lateral wall of the nasal cavity is high, the maxillary sinus is involved, the recurrence rate of the frontal recess is high, the middle turbinate is not seen, and the carcinogenesis is 1.85. Conclusion: the reason of recurrence is mainly related to the preoperative misdiagnosis as polyp, the number of operations and the location of the lesion. Involvement of frontal recess and anterior and inferior wall of maxillary sinus were the risk factors of recurrence. Preoperative accurate diagnosis of primary tumor site and complete resection during operation were the most effective means to cure the disease. Postoperative nasal endoscopy and nasal CT examination were the effective methods to evaluate the recurrence.
【作者单位】：大连医科大学附属二院耳鼻咽喉科;
【基金】：辽宁省自然科学基金(No:20102051)
【分类号】：R739.62

【共引文献】