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目的回顾探讨鼻内镜手术治疗鼻腔及鼻窦内翻性乳头状瘤的疗效及按手术入路选择。方法分析2003年8月至2009年8月经鼻内镜手术治疗的病理和临床诊断为鼻腔及鼻窦内翻性乳头状瘤并完成术后随访2年以上病例26例,术前做鼻内镜检查及鼻窦CT扫描,内镜下行鼻腔及鼻窦内翻性乳头状瘤切除术。按照Krouse分类法分为4级:Ⅰ级8例,Ⅱ级15例,Ⅲ级3例,Ⅳ级0例。结果术后随访1～2年,26例患者术后复发2例。结论鼻内镜手术是治疗KrouseⅠ～Ⅱ级鼻腔及鼻窦内翻性乳头状瘤的一种安全有效方法,此方法的优点为视野清楚、创伤少、出血量少、复发率低;对于肿瘤Ⅲ级以上涉及上颌窦、额窦等病变广泛的患者,采用联合进路可以避免手术盲区,减少肿瘤残留,降低复发率。
Objective To retrospectively explore the efficacy of endoscopic sinus surgery for nasal and sinus inverted papilloma and select the surgical approach. Methods The pathology and clinical diagnosis of nasal and sinus inverted papilloma treated by endoscopic sinus surgery from August 2003 to August 2009 were analyzed and 26 cases were followed up for more than 2 years. Nasal endoscopy And CT scan of nasal cavity, endoscopic nasal and sinus inverted papilloma resection. Divided into 4 levels according to Krouse classification: Ⅰ grade in 8 cases, Ⅱ grade in 15 cases, Ⅲ grade in 3 cases, Ⅳ grade in 0 cases. Results The patients were followed up for 1 to 2 years and 26 patients relapsed in 2 cases. Conclusions Endoscopic sinus surgery is a safe and effective method for the treatment of inverted papilloma of nasal and sinus of Krouse Ⅰ ~ Ⅱ. The advantages of this method are clear vision, less trauma, less bleeding and low recurrence rate. The above involves the maxillary sinus, frontal sinus and other lesions in patients with extensive, the use of joint approach to avoid blind surgery, reduce tumor residues and reduce the recurrence rate.