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[鼻腔鼻窦内翻性乳头状瘤复发相关因素分析]

[Analysis of the recurrence related factors of sinonasal inverted papilloma].

作者信息

Wang M H, Guan B, Yu A M, Dai B Y, Yan Q, Chen S S

机构信息

Department of Otorhinolaryngology Head and Neck Surgery, Xiangya No.2 Hospital of Central South University, Changsha, 410000, China.

Department of Otorhinolaryngology Head and Neck Surgery, Jiangsu Subei People's Hospital.

出版信息

Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2017 Dec 20;31(24):1927-1930. doi: 10.13201/j.issn.1001-1781.2017.24.014.

Abstract

To evaluate the influence risk factors of recurrence and the methods for reducing recurrence of sinonasal inverted papilloma (SNIP). Clinical data of 34 patients with SNIP were analyzed retrospectively. All of them were unilateral onset. The diagnosis was confirmed pathologically and the range of lesions was determined by endoscopic and imaging examination; clinical classification according to Krouse classification method; All operations were performed under nasal endoscope, of which 20 cases were operated by simple nasal endoscope, and 14 cases were operated by endoscopic anterior lacrimal recess approach. The patients were followed up for 12-36 months. The curative effects were observed and the prognostic factors of the patients were analyzed. Thirty-four cases of SNIP patients with postoperative recurrence rate was 17.65% (6/34); simple nasal endoscopic surgery in 20 cases, the recurrence rate was 25.00%(5/20); endoscopic anterior lacrimal recess approach in 14 cases, the recurrence rate was 7.14%(1/14), the difference was statistically insignificant (χ²=1.807, >0.05). Four cases in stage Ⅰ had no recurrence;20 cases in stage Ⅱ, the recurrence rate was 15.0%(3/20); 9 cases in stage Ⅲ, the recurrence rate was 33.3%(3/9); 1 case in stage Ⅳ had no recurrence, the recurrence rate of the patients with different stages were statistically insignificant (χ²=2.692, >0.05). Simple endoscopic resection of the tumor and endoscopic anterior lacrimal recess surgery are effective methods for the treatment of SNIP. The nasal surgery history and tumor origin are the risk factors for recurrence. The operation completely tumorresection,detailed preoperative examination and postoperative regular endoscopic examination are the keys to preventing recurrence.

摘要

评估鼻窦内翻性乳头状瘤(SNIP)复发的影响危险因素及降低复发的方法。回顾性分析34例SNIP患者的临床资料。所有患者均为单侧发病。经病理确诊,通过内镜及影像学检查确定病变范围;按Krouse分类法进行临床分类;所有手术均在鼻内镜下进行,其中单纯鼻内镜手术20例,内镜下前泪隐窝入路手术14例。对患者进行12 - 36个月的随访。观察疗效并分析患者的预后因素。34例SNIP患者术后复发率为17.65%(6/34);单纯鼻内镜手术20例,复发率为25.00%(5/20);内镜下前泪隐窝入路手术14例,复发率为7.14%(1/14),差异无统计学意义(χ² = 1.807,>0.05)。Ⅰ期4例无复发;Ⅱ期20例,复发率为15.0%(3/20);Ⅲ期9例,复发率为33.3%(3/9);Ⅳ期1例无复发,不同分期患者的复发率差异无统计学意义(χ² = 2.692,>0.05)。单纯内镜下肿瘤切除及内镜下前泪隐窝手术是治疗SNIP的有效方法。鼻部手术史及肿瘤起源是复发的危险因素。手术彻底切除肿瘤、术前详细检查及术后定期内镜检查是预防复发的关键。

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