St Paul's Sinus Centre, St Paul's Hospital, Vancouver, BC, Canada.
Rhinology. 2010 Sep;48(3):358-63. doi: 10.4193/Rhin09.105.
To demonstrate that computer-assisted endoscopic management of inverted papillomas yields excellent long-term results in terms of preventing recurrence and minimizing significant morbidity and mortality.
A retrospective chart review of patients who are being followed up for tumour recurrence or have undergone tumour removal between 2000 and 2008. All cases were undertaken using the GE Instatrak 3500+ navigation system.
Inverted papillomas are the most common tumour managed endoscopically (57% of all sinonasal tumours) with 76 patients seen over the last 8 years. Approximately 50% of these cases had undergone previous surgery in another centre where the tumour was either not recognized or the resection was incomplete. Twentynine percent of these patients had a recurrence but only three required a revision procedure using an open approach; otherwise recurrences were successfully managed endoscopically. Endoscopic recurrence during the first half was 32% (versus 14% for open procedures), dropping to a recurrence rate of 11% in the latter period.
Endoscopic management of inverted papillomas allows good control of the disease and avoids unnecessary morbidity associated with open procedures. Although there is a higher initial recurrence rate, these recurrences can be successfully managed endoscopically, and computer navigation can be a useful adjunct in achieving this.
证明计算机辅助内镜下处理内翻性乳头状瘤在预防复发、最大限度降低显著发病率和死亡率方面具有出色的长期效果。
回顾性分析了 2000 年至 2008 年间接受肿瘤复发随访或肿瘤切除的患者的病历。所有病例均采用 GE Instatrak 3500+导航系统进行。
内翻性乳头状瘤是最常见的内镜下处理的肿瘤（占所有鼻窦肿瘤的 57%），过去 8 年共观察到 76 例患者。这些病例中约有 50%曾在另一家中心接受过手术，但肿瘤未被识别或切除不完整。这些患者中有 29%出现复发，但只有 3 例需要采用开放式手术进行修正；否则，复发均通过内镜成功处理。前半段内镜复发率为 32%（开放式手术为 14%），后半段复发率降至 11%。
内镜处理内翻性乳头状瘤可有效控制疾病，避免开放式手术相关的不必要发病率。虽然初始复发率较高，但这些复发可以通过内镜成功处理，而计算机导航可以作为实现这一目标的有用辅助手段。
