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鼻内镜下鼻咽血管纤维瘤切除术成功的因素分析

Analysis of factors in successful nasal endoscopic resection of nasopharyngeal angiofibroma.

作者信息

Ye Dong, Shen Zhisen, Wang Guoli, Deng Hongxia, Qiu Shijie, Zhang Yuna

机构信息

a Department of Otorhinolaryngology - Head and Neck Surgery , Lihuili Hospital of Ningbo University , Ningbo , PR China.

出版信息

Acta Otolaryngol. 2016;136(2):205-13. doi: 10.3109/00016489.2015.1099734. Epub 2015 Oct 23.

Abstract

CONCLUSIONS

Endoscopic resection of nasopharyngeal angiofibroma is less traumatic, causes less bleeding, and provides a good curative effect. Using pre-operative embolization and controlled hypotension, reasonable surgical strategies and techniques lead to successful resection tumors of a maximum Andrews-Fisch classification stage of III.

OBJECTIVE

To investigate surgical indications, methods, surgical technique, and curative effects of transnasal endoscopic resection of nasopharyngeal angiofibroma, this study evaluated factors that improve diagnosis and treatment, prevent large intra-operative blood loss and residual tumor, and increase the cure rate.

METHODS

A retrospective analysis was performed of the clinical data and treatment programs of 23 patients with nasopharyngeal angiofibroma who underwent endoscopic resection with pre-operative embolization and controlled hypotension. The surgical method applied was based on the size of tumor and extent of invasion. Curative effects were observed.

RESULTS

No intra-operative or perioperative complications were observed in 22 patients. Upon removal of nasal packing material 3-7 days post-operatively, one patient experienced heavy bleeding of the nasopharyngeal wound, which was treated compression hemostasis using post-nasal packing. Twenty-three patients were followed up for 6-60 months. Twenty-two patients experienced cure; one patient experienced recurrence 10 months post-operatively, and repeat nasal endoscopic surgery was performed and resulted in cure.

摘要

结论

鼻内镜下切除鼻咽血管纤维瘤创伤小、出血少,疗效良好。采用术前栓塞和控制性低血压,合理的手术策略和技术可成功切除最大Andrews-Fisch分级为Ⅲ级的肿瘤。

目的

探讨经鼻内镜切除鼻咽血管纤维瘤的手术适应证、方法、手术技巧及疗效,本研究评估了改善诊断和治疗、预防术中大出血和残留肿瘤以及提高治愈率的因素。

方法

回顾性分析23例行术前栓塞和控制性低血压下鼻内镜切除的鼻咽血管纤维瘤患者的临床资料和治疗方案。根据肿瘤大小和侵犯范围采用手术方法。观察疗效。

结果

22例患者未观察到术中或围手术期并发症。术后3 - 7天取出鼻腔填塞物时,1例患者鼻咽部伤口大出血,采用后鼻孔填塞压迫止血治疗。23例患者随访6 - 60个月。22例患者治愈;1例患者术后10个月复发,再次行鼻内镜手术治愈。

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