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鼻窦内翻性乳头状瘤恶变侵犯翼腭窝的治疗:一例报告

Treatments in sinonasal inverted papilloma malignancy invading the pterygopalatine fossa: A case report.

作者信息

Jiang Linlan, Wang Liwen, Gao Shuyi, Jiao Yuenong, Gong Huicheng

机构信息

Guangzhou Twelfth People's Hospital, Guangzhou, China.

Institute of Otorhinolarngology, Head and Neck Surgery, Guangzhou Medical University, Guangzhou, China.

出版信息

Sci Prog. 2024 Oct-Dec;107(4):368504241306895. doi: 10.1177/00368504241306895.

Abstract

Sinonasal inverted papilloma (SNIP) is less malignant and usually occur in the maxillary sinus. However, cases invading the pterygopalatine fossa are extremely rare. In this article, we describe a rare case of a man in his early 60s who presented with left nasal congestion, headache, epistaxis, and facial numbness. The patient underwent a comprehensive treatment primarily based on surgery. Nasal endoscopy showed that the mass had invaded the left infratemporal fossa laterally and was poorly separated from the internal maxillary artery, which increased the complexity and difficulty of the surgery. In addition, the patient had previously undergone nasal cavity surgery, which made the surgery more challenging. In order to reduce the risk of recurrence, we exposed the infratemporal fossa region under nasal endoscopic guidance with a combined labial and gingival incision, and completely removed the tumor base and tumor margins. There were no postoperative complications and no recurrence was observed during the 2-year follow-up period.

摘要

鼻窦内翻性乳头状瘤(SNIP)恶性程度较低,通常发生在上颌窦。然而,侵犯翼腭窝的病例极为罕见。在本文中,我们描述了一例罕见病例,一名60岁出头的男性,表现为左侧鼻塞、头痛、鼻出血和面部麻木。患者接受了以手术为主的综合治疗。鼻内镜检查显示肿物已向外侵犯左侧颞下窝,与上颌内动脉分界不清,增加了手术的复杂性和难度。此外,患者既往曾接受鼻腔手术,这使得手术更具挑战性。为降低复发风险,我们在鼻内镜引导下经唇龈联合切口暴露颞下窝区域,完整切除肿瘤基底及肿瘤边缘。术后无并发症发生,在2年的随访期内未观察到复发。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8cfe/11662316/8fb21efaa1f4/10.1177_00368504241306895-fig1.jpg

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