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目的:探讨鼻中隔恶性肿瘤的手术径路。方法:16例中,鼻侧切开术8例、鼻内镜下手术5例、面中部揭翻术2例、经腭入路1例。并对其病理学特征、手术径路及预后进行回顾性分析。结果:16例中,鼻中隔鳞状细胞癌7例、腺样囊性癌4例、恶性黑色素瘤3例、腺癌1例、黏液表皮样癌1例。术后随访1~10年,其中失访1例,死亡2例,带瘤生存3例,无瘤生存10例。病死率为12.5%,带瘤生存率为18.8%,无瘤生存率为62.5%。结论:鼻中隔恶性肿瘤手术径路应根据病变范围、患者年龄采取不同的术式。如病变局限于鼻中隔前下部或后部,则鼻内镜下切除;如病变涉及鼻中隔全部或累及鼻腔其他部位,则以鼻侧切开为宜;若患者年龄较小,则以面中部揭翻或经腭入路为宜。
Objective: To explore the surgical approach of malignant nasal septum. Methods: In 16 cases, nasal incision in 8 cases, endoscopic surgery in 5 cases, median facial revelation in 2 cases, and palatal approach in 1 case. The pathological features, surgical approach and prognosis were retrospectively analyzed. Results: In 16 cases, there were 7 cases of squamous cell carcinoma of nasal septum, 4 cases of adenoid cystic carcinoma, 3 cases of malignant melanoma, 1 case of adenocarcinoma and 1 case of mucoepidermoid carcinoma. The patients were followed up for 1 to 10 years, of which 1 was lost to follow-up, 2 died, 3 survived with tumor, and 10 survived without disease. The case fatality rate was 12.5%, tumor-bearing survival rate was 18.8%, and tumor-free survival rate was 62.5%. Conclusion: Surgical approach to malignant nasal septum surgery should be based on the extent of the disease, the patient’s age to take different surgical procedures. If the lesion is limited to the lower part or posterior part of the nasal septum, the endoscopic resection; if the disease involves the nasal septum, or involving the other parts of the nasal cavity, nasal incision is appropriate; if the patient is younger, the middle of the face uncovered Or via the palate approach is appropriate.