Department of Otolaryngology Head and Neck Surgery, Louisiana State University (LSU) Health Sciences Center, New Orleans, LA, USA.
Int Forum Allergy Rhinol. 2011 Sep-Oct;1(5):405-8. doi: 10.1002/alr.20016. Epub 2011 Aug 16.
Nasopharyngeal papillomatosis is uncommon. Access and visualization make excision difficult, increasing the risk for recurrence. We present a novel technique for excision of nasopharyngeal papillomatosis.
A case series of 3 patients with recurrent papilloma of the nasopharynx (NP) were treated with endoscopic transnasal coblation. We used an Arthrocare EVac 70 Coblator (setting: coblation-9, coagulation-5).
Using transnasal endoscopic coblation, we performed complete excision in 3 patients with recurrent papilloma of the NP (4 total procedures). There were no complications. One patient had a minor recurrence, which was successfully re-excised with the same technique.
Nasopharyngeal papillomas can be difficult to excise. Multiple techniques have been described using a transoral approach, with no reported complications. However, surgical access to the entire NP is more challenging with a transoral approach. Also, bleeding and poor visualization secondary to bleeding can be encountered with these techniques. These problems were not encountered with transnasal coblation. The absence of eschar and decreased collateral thermal damage make coblation preferable to cauterization or laser excision. This proposed technique enables more complete visualization and removal of disease, which may reduce recurrence rates.
鼻咽部乳头状瘤并不常见。由于进入和可视化困难，使得切除变得困难，增加了复发的风险。我们提出了一种切除鼻咽部乳头状瘤的新方法。
对 3 例复发性鼻咽部（NP）乳头状瘤患者采用经鼻内镜低温射频消融术治疗。我们使用 Arthrocare EVac 70 低温射频消融器（设置：射频-9，凝血-5）。
使用经鼻内镜低温射频消融术，我们对 3 例复发性 NP 乳头状瘤患者（共 4 例）进行了完全切除。无并发症发生。1 例患者有轻微复发，采用相同技术成功再次切除。
鼻咽部乳头状瘤很难切除。已经描述了多种使用经口入路的技术，没有报道并发症。然而，经口入路的手术方式更难以完全切除整个 NP。此外，这些技术可能会因出血和出血引起的不良可视化而遇到问题。这些问题在经鼻低温射频消融术中并未遇到。低温射频消融术无焦痂形成，减少了热损伤的扩散，因此优于电灼或激光切除。这种拟议的技术可以更全面地观察和清除病变，从而降低复发率。
