The Clinical Research Of Curative Effects Of Nasal Inverted Papilloma Treated By Intranasal Endoscopic Approach

BackgroundNasal inverted papilloma is a common tumor for mucous membrane of nasal cavity and sinus.It can destroy the bone wall around and the normal anatomic structure, meanwhile, papilloma is not only to recurrence but also to worsen. So the preferred treatment is operation,and the principle is to supply a radical cure. The success of surgery lies in thoroughly removeing the affected nasal and paranasal sinus group with the adjacent mucosa and bone around. The traditional operation method of the tumor is external nasal approach. Yet, the way has serious trauma and face scar, and especially the protection of nasal sinuses is not enough. Lots of clinical data confirmed the nasal outer diameter road and the therapeutic effect of nasal endoscopic surgery and there was no significant difference. In recent years, with the development of nasal endoscopic minimally invasive technology, application of sophisticated surgical anatomic lesions also gradually mature technology processing, patients are also more likely to accept.ObjectiveTo compare the effect of Simple nasal endoscopic surgery and Caldwell Luc through the review and analysis of45patients. Discusses the value of application for nasal endoscopy and provide more accurate diagnosis and treatment plan.Method45cases were retrospectively analyzed, who were accepted surgical treatment fo rnasal inerted papilloma in jinan central hospital otolaryngology examination from2006.3to2011.1, with postoperative follow-up records, registration form, imaging methods,the surgical treatment and postoperative relapse. Classification:By means of Krouse, there are eight patients of grade Ⅰ, fifteen of grade Ⅱ,twenty-two of grade Ⅲ.Surgery method:Simple nasal endoscopic surgery and Caldwell Luc with nasal endoscopy assisted surgery. Methods choose:Among the forty-five cases, thirty-six were accepted Simple nasal endoscopic surgery, nine accepted the other surgery. eight patients of grade Ⅰ、fifteen of grade Ⅱ, and thirteen of grade were accepted Simple nasal endoscopic surgery, and others were accepted Caldwell Luc with nasal endoscopy assisted surgery. Review and follow up:After admitted, all the patients should be re-examined punctually, everyone was been followed-up for38months on average. These data were statistical analysed and compared Statistical analysis:X2test was used to check out the relationship of recurrence from different groups. a=0.05.ResultThe recurrence rate of grade Ⅰ under Simple nasal endoscopic surgery was12.5%, the rate of grade Ⅱ and grade Ⅲ ware13.3%and30.8%, meanwhile the rate of gradeⅢunderCaldwell Luc was11.1%, the overall recurrence rate of grade Ⅲwas22.7%. The rate of gradelllwas higher than grade Ⅰ and Ⅱ. But there was no statistic differences. The recurrence rate of grade Ⅲmaxillary sinus tumor about Simple nasal endoscopic surgery was higher than Caldwell Luc, and there were statistically significant differences.Conclusion1. The advantages of nasal endoscopic surgery:No facial incision, light facial swelling, shorter hospitalization time, to reduce postoperative pain and numbness, conform to the minimally invasive concept of modern medicine.2.The methods of surgery should lie in the Primary tumor location and affected site:(1) we can clean the tumor only for the grade Ⅰ,which was Located in the nasal cavity and the operator can see it compeletely.(2) Caldwell Luc surgery is our better choice of grade Ⅲmaxillary sinus tumor.3. the recurrence rate:.The recurrence rate of grade Ⅰ and Ⅱ is between10%～20%,and the rate of grade Ⅲ is between20%～30%, But there is no statistic differences. The recurrence rate of maxillary sinus tumor is higher than Caldwell Luc, and there are statistically significant differences.4. Nasal endoscopic inerted papilloma resection is a safe, effective and minimally invasive treatment. Nearly all the tumors grade Ⅰ and Ⅱ and part of grade Ⅲ could use the simple nasal endoscopic surgery.PS:In this retrospective study, due to objective conditions, there were few grade Ⅳ patients, so we gave up this information.