Myers E N, Fernau J L, Johnson J T, Tabet J C, Barnes E L
Department of Otolaryngology, University of Pittsburgh, School of Medicine.
Laryngoscope. 1990 May;100(5):481-90. doi: 10.1288/00005537-199005000-00008.
This paper updates a 1981 report on the management of inverted papilloma. In that report, routine lateral rhinotomy with en bloc resection of the lateral nasal wall, including the entire schneiderian membrane, was recommended. This report emphasizes the use of computed tomography scanning in management planning. Of 33 patients with inverted papilloma treated between 1969 and 1987, 7 had associated squamous cell carcinoma. Twenty-two patients with IP alone were treated with medial maxillectomy; however, 3 patients have been successfully treated with either a Caldwell-Luc/ethmoidectomy or an external ethmoidectomy for localized disease. The use of computed tomography capable of higher resolution allowed preoperative determination of the extent of disease, enabling the surgeon to plan the surgery more precisely. Patients were followed for an average of 9.6 years. Recurrent disease occurred in one patient (4%) following a lateral rhinotomy/medial maxillectomy approach. The principles set forth in this series of patients remain the same as those previously described due to the unique characteristics of this tumor: its ability to destroy bone, its tendency to recur, and its association with malignancy. The technique of lateral rhinotomy and en bloc excision of the lateral nasal wall, followed by meticulous removal of all mucosa in the ipsilateral paranasal sinuses, remains the standard therapy.
本文更新了一份1981年关于内翻性乳头状瘤治疗的报告。在那份报告中，建议采用常规外侧鼻切开术整块切除外侧鼻壁，包括整个鼻窦黏膜。本报告强调在治疗规划中使用计算机断层扫描。在1969年至1987年期间接受治疗的33例内翻性乳头状瘤患者中，7例伴有鳞状细胞癌。22例单纯内翻性乳头状瘤患者接受了上颌骨内侧切除术；然而，3例局限性疾病患者成功接受了柯-陆氏手术/筛窦切除术或外部筛窦切除术。使用具有更高分辨率的计算机断层扫描能够在术前确定疾病范围，使外科医生能够更精确地规划手术。患者平均随访9.6年。1例患者（4%）在外侧鼻切开术/上颌骨内侧切除术后出现疾病复发。由于该肿瘤的独特特征：其破坏骨质的能力、复发倾向以及与恶性肿瘤的关联，本系列患者所阐述的原则与先前描述的相同。外侧鼻切开术及外侧鼻壁整块切除术，随后仔细清除同侧鼻窦内所有黏膜的技术，仍然是标准治疗方法。
