鼻内镜下鼻腔内翻性乳头状瘤低温等离子射频手术治疗的初步观察

目的 探讨鼻内镜下低温等离子射频手术治疗鼻腔内翻性乳头状瘤的方法 和初步疗效.方法 回顾性分析2008年7月至2009年1月诊治的8例鼻腔内翻性乳头状瘤患者的临床资料,全部患者均在鼻内镜下实施手术.按Krouse分级,其中Ⅰ级病变1例和Ⅱ级病变6例完全采用低温等离子射频完成手术,Ⅲ级病变1例采用电动吸割器结合低温等离子射频完成手术.结果 术中出血少,除1例复发性鼻腔内翻性乳头状瘤患者出血约200 ml外,余7例患者出血量为2～50 ml,中位数出血量为44 ml.手术时间短,为15～50 min,中位数手术时间为31 min.术后疼痛轻微,术后第2天出院.术后2个月术腔完全上皮化,无并发症.随访2～6个月,中位随访时间4个月,8例均未见复发.结论低温等离子射频手术治疗鼻腔内翻性乳头状瘤具有出血少,损伤小,手术时间短,术后疼痛轻微等优势,对于Ⅰ、Ⅱ级病变可做到肿瘤整块彻底切除,是一种微创治疗鼻腔内翻性乳头状瘤的手术方法 .

Endoscopic surgery using the low-temperature plasma radiofrequency for nasal inverted papilloma

Objective To evaluate the effect of endoscopic surgery using the low- temperature plasma radiofrequency for nasal inverted papilloma. Methods In a retrospective study, clinical data of 8 patients underwent endoscopic surgery were analyzed since July 2008. Tumor stage according to Krouse was T1:1, T2:6, T3:1, T4:0, respectively. T1 and T2 lesions were completed excised using the low-temperature plasma radiofrequency, T3 lesions were excised using micredebrider combined with plasma radiofrequency. Results The average blood loss was about 20 ml, with the exception of one patients with recurrent nasal inverted papilloma about 200 ml. Shorter operative time, minimal postoperative pain, epithelization of nasal cavity was seen 2 months postoperatively. There were no complications. All patients were followed-up for 2 - 6 months, with no recurrence. Conclusions Surgical treatment of nasal inverted papilloma using low-temperature plasma radiofrequency had following advantages: less blood loss , complete en bloc tumor resection, mild injury, short surgery time, mild postoperative pain. In summary, low-temperature plasma radiofrequency is a minimally invasive treatment for nasal inverted papilloma.