Zheng Chun-Quan, Sun Bao-Bin, Liu Ying, Wang De-Hui
Department of Otorhinolaryngology, Affiliated Eye Ear Nose Throat Hospital of FuDan University, Shanghai 200031, China.
Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2005 Apr;40(4):283-6.
To evaluate the effect of endoscopic resection and traditional procedure in the management of sinonasal inverted papilloma with a staging system based on endoscopic examination of the nasal cavity and computed tomography (CT) scan evaluation.
Two hundred and twenty-two patients with sinonasal inverted papilloma treated surgically were retrospectively reviewed. There were 23 cases in stage I; 119 cases in stage II; 65 cases in stage III and 15 cases in stage IV. Among these patients, 122 cases were treated endoscopically; 100 cases were treated by traditional surgical techniques, including 56 cases with lateral rhinotomy; 27 cases with intranasal approach and 15 cases with Caldwell-Luc technique.
The inverted papilloma was removed completely and no serious complications were encountered by all four kinds of techniques used. With an average follow-up of 3. 8 years, the recurrence rate for endoscopic group was 14.8% (18/122, four patients were in group I; nine in group II; four in group III; and one patient in group IV. No recurrence was found in group III who underwent endoscopic excision combined with Caldwell-Luc procedure. The recurrence rate for lateral rhinotomy group was 33. 9% (19/56, one patients in group I; six in group II; nine in group III; three in group IV). The recurrence rate for intranasal approach group was 51.9% (14/27, two patients were in group I; ten in group II; and two in group III). The recurrence rate for Caldwell-Luc procedure group was 29.4% (5/17, all in group II and group III). Regardless of approaches, patients who had primary resection had a recurrence of 26. 8%, whereas those with secondary resection had a recurrence of 20. 9% (P = 0.39).
The endoscopic surgical technique was proved to be a better method for treating sinonasal inverted papilloma in stage I and stage II. Better results for patients in stage III would be achieved by combining endoscopic technique with Caldwell-Luc procedure. As to patients with stage IV, radical external approaches should be considered.
基于鼻腔内镜检查和计算机断层扫描（CT）评估的分期系统，评价内镜切除术和传统手术方法在治疗鼻窦内翻性乳头状瘤中的效果。
回顾性分析222例接受手术治疗的鼻窦内翻性乳头状瘤患者。其中，I期23例；II期119例；III期65例；IV期15例。这些患者中，122例行内镜手术治疗；100例行传统手术技术治疗，包括56例行鼻侧切开术；27例行鼻内入路手术；15例行柯-陆氏手术。
所有四种手术技术均完全切除了内翻性乳头状瘤，且未出现严重并发症。平均随访3.8年，内镜手术组的复发率为14.8%（18/122，I组4例；II组9例；III组4例；IV组1例。接受内镜切除联合柯-陆氏手术的III组未发现复发。鼻侧切开术组的复发率为33.9%（19/56，I组1例；II组6例；III组9例；IV组3例）。鼻内入路手术组的复发率为51.9%（14/27，I组2例；II组10例；III组2例）。柯-陆氏手术组的复发率为29.4%（5/17，均在II组和III组）。无论采用何种手术入路，初次切除的患者复发率为26.8%，而二次切除的患者复发率为20.9%（P = 0.39）。
内镜手术技术被证明是治疗I期和II期鼻窦内翻性乳头状瘤的较好方法。对于III期患者，将内镜技术与柯-陆氏手术相结合可取得更好的效果。对于IV期患者，应考虑采用根治性外部手术入路。
