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经鼻内镜下上颌窦内侧切除术治疗复发性上颌窦内翻性乳头状瘤

Transnasal endoscopic medial maxillectomy in recurrent maxillary sinus inverted papilloma.

作者信息

Kamel Reda H, Abdel Fattah Ahmed F, Awad Ayman G

出版信息

Rhinology. 2014 Dec;52(4):381-5. doi: 10.4193/Rhino13.230.

Abstract

BACKGROUND

Maxillary sinus inverted papilloma entails medial maxillectomy and is associated with high incidence of recurrence.

OBJECTIVE

To study the impact of prior surgery on recurrence rate after transnasal endoscopic medial maxillectomy.

METHODOLOGY

Eighteen patients with primary and 33 with recurrent maxillary sinus inverted papilloma underwent transnasal endoscopic medial maxillectomy. Caldwell-Luc operation was the primary surgery in 12 patients, transnasal endoscopic resection in 20, and midfacial degloving technique in one. The follow-up period ranged between 2 to 19.5 years with an average of 8.8 years.

RESULTS

Recurrence was detected in 8/51 maxillary sinus inverted papilloma patients (15.7 %), 1/18 of primary cases (5.5 %), 7/33 of recurrent cases (21.2 %); 3/20 of the transnasal endoscopic resection group (15%) and 4/12 of the Caldwell-Luc group (33.3%). Redo transnasal endoscopic medial maxillectomy was followed by a single recurrence in the Caldwell-Luc group (25%), and no recurrence in the other groups.

CONCLUSION

Recurrence is more common in recurrent maxillary sinus inverted papilloma than primary lesions. Recurrent maxillary sinus inverted papilloma after Caldwell-Luc operation has higher incidence of recurrence than after transnasal endoscopic resection.

摘要

背景

上颌窦内翻性乳头状瘤需要进行上颌骨内侧切除术,且复发率较高。

目的

研究既往手术对经鼻内镜上颌骨内侧切除术后复发率的影响。

方法

18例原发性上颌窦内翻性乳头状瘤患者和33例复发性患者接受了经鼻内镜上颌骨内侧切除术。12例患者的初次手术为柯-陆氏手术,20例为经鼻内镜切除术,1例为面中部掀翻术。随访时间为2至19.5年,平均8.8年。

结果

51例上颌窦内翻性乳头状瘤患者中有8例复发(15.7%),其中原发性病例1/18(5.5%),复发性病例7/33(21.2%);经鼻内镜切除组20例中有3例(15%),柯-陆氏手术组12例中有4例(33.3%)。柯-陆氏手术组再次行鼻内镜上颌骨内侧切除术后有1例复发(25%),其他组无复发。

结论

复发性上颌窦内翻性乳头状瘤比原发性病变更易复发。柯-陆氏手术后复发性上颌窦内翻性乳头状瘤的复发率高于经鼻内镜切除术后。

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