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目的:探讨鼻内镜下或鼻内镜辅助下手术治疗复发性鼻腔鼻窦内翻性乳头状瘤(SIP)的疗效。方法:回顾性分析28例复发性SIP患者的临床资料。全部患者既往均有鼻腔鼻窦手术史,其中复发1次者17例,复发2次者10例,复发3次者1例。全部患者均接受鼻内镜或鼻内镜辅助下手术。结果:随访2~6年,仅3例在手术后复发,其余25例在随访期内均未见复发。5例患者术后发现鳞状细胞癌或灶性恶变,接受放疗并随访至今,1例复发2次并再次行手术治疗,2例死亡,2例未见复发。结论:鼻内镜下或鼻内镜辅助下手术是治疗SIP的首选方法,优势在于创伤小、并发症少和有利于保护鼻腔功能。对于有恶变者采取术后放化疗综合治疗,可提高长期生存率。彻底切除肿瘤和术后定期随访是治疗成功的关键。
Objective: To investigate the efficacy of nasal endoscopic or endoscopic assisted surgery in the treatment of recurrent nasal sinus inverted papilloma (SIP). Methods: The clinical data of 28 patients with recurrent SIP were analyzed retrospectively. All patients had a history of nasal sinus surgery in the past, including 17 cases of recurrent 1 times, 10 cases of recurrent 2 times, 1 case of recurrence 3 times. All patients underwent endoscopic or endoscopic assisted surgery. Results: During the follow-up of 2 to 6 years, only 3 cases relapsed after operation, and the remaining 25 cases showed no recurrence during the follow-up period. Five patients were found squamous cell carcinoma or focal malignancy after surgery, received radiotherapy and follow-up to date, one case of relapse 2 times and again underwent surgical treatment, 2 patients died and 2 patients had no recurrence. CONCLUSIONS: Endoscopic or endoscopic assisted surgery is the preferred method of treatment for SIP, with the advantage of less trauma, less complications and protection of nasal function. For malignant patients to take postoperative radiotherapy and chemotherapy combined treatment, can improve long-term survival. Thorough resection of the tumor and regular postoperative follow-up are the keys to successful treatment.