CAJ | 학술논문

目的探讨上颌窦内翻性乳头状瘤鼻内镜下外科治疗的疗效.方法回顾性分析2000-2011年山东大学齐鲁医院收治的上颌窦内翻性乳头状瘤患者50例,其中初发患者39例,复发患者11例;Krouse分级Ⅱ级17例,Ⅲ级33例.所有患者均接受内镜经鼻或联合入路手术.根据病变范围和位置的不同,选择采用不同的手术入路及手术方式.术中切除肿瘤基底部后,以电凝或电刀进一步处理基底部.1例内翻性乳头状瘤伴重度不典型增生的患者术后接受放疗.结果 50例患者随访3～14年,术后复发7例,均出现于术后2年内,其中恶变并死亡1例.术后出现溢泪2例、上颌窦唇龈沟瘘2例、面部麻木4例、刀口出血1例,经处理后均治愈.结论内镜经鼻或辅助联合入路对上颌窦内翻性乳头状瘤切除满意,根据病变不同情况选择合适的入路并对肿瘤基底部进行仔细的处理是手术成功的关键.
목적 탐토상합두내번성유두상류비내경하외과치료적료효.방법 회고성분석2000-2011년산동대학제로의원수치적상합두내번성유두상류환자50례,기중초발환자39례,복발환자11례;Krouse분급Ⅱ급17례,Ⅲ급33례.소유환자균접수내경경비혹연합입로수술.근거병변범위화위치적불동,선택채용불동적수술입로급수술방식.술중절제종류기저부후,이전응혹전도진일보처리기저부.1례내번성유두상류반중도불전형증생적환자술후접수방료.결과 50례환자수방3～14년,술후복발7례,균출현우술후2년내,기중악변병사망1례.술후출현일루2례、상합두진간구루2례、면부마목4례、도구출혈1례,경처리후균치유.결론 내경경비혹보조연합입로대상합두내번성유두상류절제만의,근거병변불동정황선택합괄적입로병대종류기저부진행자세적처리시수술성공적관건.
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 Ⅱ and 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.