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[上颌窦内翻性乳头状瘤的内镜手术]

[Endoscopic surgery for maxillary sinus inverted papilloma].

作者信息

Zhang Liqiang, Li Xuezhong, Shi Li, Cai Xiaolan, Ye Ping, Feng Xin, Pan Xinliang

机构信息

Department of Otorhinolaryngology, Qilu Hospital of Shandong University, Ji'nan 250012, China.

Department of Otorhinolaryngology, Qilu Hospital of Shandong University, Ji'nan 250012, China. Email:

出版信息

Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2014 Sep;49(9):721-5.

Abstract

OBJECTIVE

To evaluate the effect of endoscopic surgery for maxillary sinus inverted papilloma.

METHODS

From 2000 to 2011, 50 patients with maxillary sinus inverted papilloma were treated with intranasal endoscopic surgery or combined approach. Among them, 39 cases were primary and 11 cases were recurrent, which included 17 patients with Krouse stage IIand 33 cases with Krouse stage III. Different surgical approaches were selected according to the range and positions of the lesions. One case with severe atypical hyperplasia received postoperative radiotherapy.

RESULTS

All cases were followed up for 3-14 years, 7 cases recurred. All occurrence within 2 years after operation. Malignant change and death was found in 1 case. After operation, epiphora occurred in 2 cases, maxillary sinus labiogingival groove fistula occurred in 2 cases, facial numbness occurred in 4 cases and incision hemorrhage occurred in 1 case. All the complications were cured after appropriate treatment.

CONCLUSIONS

Naso-endoscopic surgery or combined approach is a safe, effective and microinvasive treatment for patients with maxillary sinus inverted papilloma. Accurate selection of suitable approach according to the range and positions of the lesions and correct management of the base of the tumor are critical to the success of the operation.

摘要

目的

评估鼻内镜手术治疗上颌窦内翻性乳头状瘤的效果。

方法

2000年至2011年,50例上颌窦内翻性乳头状瘤患者接受鼻内镜手术或联合手术治疗。其中,39例为原发性,11例为复发性,包括17例KrouseⅡ期患者和33例KrouseⅢ期患者。根据病变范围和位置选择不同的手术方式。1例重度非典型增生患者术后接受放疗。

结果

所有病例随访3至14年,7例复发,均在术后2年内发生。1例发生恶变及死亡。术后2例出现溢泪,2例出现上颌窦唇龈沟瘘,4例出现面部麻木,1例出现切口出血。经适当治疗后所有并发症均治愈。

结论

鼻内镜手术或联合手术是治疗上颌窦内翻性乳头状瘤患者安全、有效且微创的方法。根据病变范围和位置准确选择合适的手术方式以及正确处理肿瘤基底是手术成功的关键。

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