鼻窦内翻性乳头状瘤的处理与治疗。

C. Ungari, E. Riccardi, G. Reale, A. Agrillo, C. Rinna, V. Mitro, F. Filiaci
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引用次数: 17

摘要

目的总结35例鼻窦内翻性乳头状瘤(IP)的手术治疗经验及随访1年后的复发率。资料:对以鼻窦炎为表现的患者进行回顾性图表回顾。35例患者是本研究的重点。所有患者术前均行TC, 5例以上患者需行钆磁共振(MR)。结果入选的35例患者中,18例患者行开放手术,4例患者行内镜和开放手术联合入路,13例患者仅行内镜入路,随访时间至少1年。我们的研究结果强调,治疗后12个月的全球成功率为93%,并且如果实现了病灶的根治性切除,则该成功率不会因所使用的方法的形态学而变化。更深入地说,在35例病例中,只有2例发现复发,并采取冠状和内镜入路治疗。结论对易复发的顽固性鼻咽癌必须进行根治性手术治疗。完全切除病变和骨周围边界锉是进行正确和明确治疗的必要条件。此外,当肿瘤位于横过眶中壁的矢状平面的中间位置,并且没有严重损害鼻窦壁时,可以考虑内镜入路。
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Management and treatment of sinonasal inverted papilloma.
AIMS The aim of this paper is to describe the surgical experience of 35 patients with Inverted Papilloma (IP) of paranasal sinuses and its recurrence rate after a year of follow-up. MATERIALS A retrospective chart review was performed on patients presenting with IP of paranasal sinuses. Thirty-five patients comprised the focus of this study. For all patients was performed a pre-surgery TC, and for more 5 patients it was necessary to perform a Magnetic Resonance (MR) with gadolinium. RESULTS Among 35 patients selected, 18 patients underwent to open surgery, 4 patients had a combined approach with endoscopy and open surgery, while 13 patients were managed only with an endoscopic approach, with a minimum of 1 year of follow-up. Our results highlighted that the global percentage of success 12 months after the treatment was 93% and it not vary according to the tipology of the approach used if a radical excision of the lesion is achieved. More in depth, among 35 cases, only 2 patients were found to have recurrences and were treated with coronal and endoscopic approach. CONCLUSION It is fundamental to underline that surgery must be carried on in a radical manner to treat these tend to recur. A complete removal of the lesion and bone peripheral border filing are essential to perform a correct and definitive treatment. Also, endoscopic approach can be taken into account when tumors are localized median to a sagittal plan crossing the orbit median wall and when they did not massively compromised paranasal sinus walls.
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