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目的研究以鼻内翻性乳头状瘤(NIP)起源为主要依据的临床分期,用以指导手术和评价术后疗效。方法 回顾性分析55例NIP手术病例。男37例,女18例,男女比例为2∶1,27～78岁。右侧23例,左侧32例,未发现双侧发病者。11例有NIP手术史。25例术前病理检查证实为NIP,按照Kamel分期,其中Ⅰ型30例、Ⅱ型25例。结果Ⅰ型NIP行鼻内镜下局部切除术(30例),Ⅱ型NIP行鼻内镜下局部切除术(4例)、鼻内镜下上颌窦内侧壁切除术(11例)、鼻内镜下双径路手术(10例)。复发率:Ⅰ型复发率为6.7%(2/30),Ⅱ型复发率为16.0%(4/25),总复发率为10.9%(6/55)。与检索资料相比复发率差异无统计学意义。结论 NIPⅠ型手术采取鼻内窥镜下局部切除术,Ⅱ型采取鼻内镜下上颌窦内壁切除术或经唇龈沟切口上颌窦前壁开窗结合经鼻内镜手术(双径路手术)。术后复发率与报道资料复发率相比没有统计学意义,说明这种基于疾病来源新的Kamel方法临床分型对手术治疗有指导意义,并且经鼻内镜鼻内翻性乳头状瘤切除和传统方法相比有较大优势。
Objective To study the clinical stage based on the origin of nasal inverted papilloma (NIP), to guide the operation and evaluate the curative effect. Methods Retrospective analysis of 55 cases of NIP surgery. 37 males and 18 females, male to female ratio of 2: 1, 27 to 78 years old. 23 cases on the right side, 32 cases on the left side, no bilateral onset was found. Eleven patients had a history of NIP surgery. Twenty-five cases were proved to be NIP by pathological examination. According to Kamel’s classification, there were 30 cases of type I and 25 cases of type II. Results NIP under local endoscopic resection (n = 30), NIP under local endoscopic resection (n = 4), endoscopic maxillary sinus medial wall resection (n = 11), intranasal Microscopic double-path surgery (10 cases). Recurrence rate: type Ⅰ recurrence rate was 6.7% (2/30), type Ⅱ recurrence rate was 16.0% (4/25), the total recurrence rate was 10.9% (6/55). There was no significant difference in the relapse rate between the retrieved data and the retrieved data. Conclusion NIP Ⅰ operation under nasal endoscopic resection, Ⅱ endoscopic sinus surgery under the wall or through the gingival sulcus incision in the anterior wall of the maxillary sinus combined endoscopic surgery (dual path surgery). Postoperative recurrence rate and reported data relapse rate was not statistically significant, indicating that the new Kamel method based on the source of the clinical classification of the disease is instructive, and endoscopic nasal inverted papilloma resection and Compared to traditional methods have greater advantages.