Clinical Analysis For300Cases Of Nasal Cavity And Paranasal Sinus Malignant Neoplasms

Malignant tumor of nasal cavity and sinus malignant tumor in theDepartment of ENT in the more common, according to national statistics, totalsystemic malignancies in2.10%~4.0%, foreign reports for0.15%~2.15%. Inthe north of our country higher incidence than the south, according to thedomestic and foreign literatures, nasal and paranasal sinus malignant tumor hascertain characteristics of incidence.In this paper, through a retrospective analysis of2002January to2011December Bethune of Jilin University Second Hospital Department of ENT allpatients (including outpatient and inpatient) in the pathological diagnosis ofmalignant tumor of nasal cavity and sinus information on malignant tumor ofnasal cavity and sinus, especially for the high incidence of olfactoryneuroblastoma patients age, sex, site the pathological types, and so on, in orderto its pathogenesis and clinical features of malignant tumor of nasal cavity andsinus, for future prevention, diagnosis and treatment to provide clinical basis,improve the diagnosis rate, low recurrence rate and mortality.Our department within10years were treated300cases of malignanttumor of nasal cavity and paranasal sinuses. Age:50-59years old age group in86cases (28.6%), the first, the60-69age group in55cases (18.3%), second, byA, B two group, malignant tumor of nasal cavity and sinus olfactoryneuroblastoma, there were statistically significant differences in agedistribution. Gender: data of300cases of the overall incidence of men thanwomen (male184cases, female116cases, male: female=1.58:1); olfactoryneuroblastoma pathogenesis is men and women (n=35, male18cases, female 17cases, male/female=1.05:1); adenoid cystic carcinoma and sarcomaincidence in women than men, A, B two group statistics chi-square test P<0.05,the difference was statistically significant. Incidence of parts: sinus in231cases,accounting for77%, among them within the sinus maxillary sinus in198cases,accounting for66%of the largest, nasal cavity in69cases, accounting for23%.Pathological types: through the A group compared with B group, squamous cellcarcinoma15.3%reduction, lymphoma in6.1%, olfactory neuroblastoma andsarcoma were increased in4.4%, inverted papilloma carcinoma in1.4%,olfactory neuroblastoma, lymphoma and sarcoma in nasal and paranasal sinusmalignant tumor in the proportion of the difference was statistically significant,P<0.05.35cases of olfactory neuroblastoma, admitted with a diagnosis of nasaltumors in23cases,12patients initially diagnosed with nasal polyps (includinghemorrhagic necrotic nasal polyps: a report of7cases), intraoperativepathological diagnosis of20cases,15cases were diagnosed by postoperativepathological return. Incidence of parts: single in27cases, multiple in8cases,single in the olfactory region in16cases,5cases with middle turbinate root,total nasal tract in6patients; multiple were located at the top of nasal cavity.The main clinical symptoms: unilateral nasal obstruction in26cases, bilateralnasal obstruction in3cases,5cases of epistaxis, blood in tears in22cases,8cases of olfactory loss, decreased visual acuity in3cases,4cases of headache,1cases with cervical lymph node metastasis. CT, center located in the nasalcavity in13cases, no peripheral sinus invasion, center of lesion ethmoid sinusin22cases, in which the limitations in the ethmoid sinus nasal cavity in8cases,invading the maxillary sinus in3cases,3cases of violations of the sphenoidsinus, frontal sinus4cases of violations, violations of the ipsilateral orbit in1cases,3cases with intracranial invasion. Kadish stage:13cases of stage Alesions confined to the nasal cavity;18cases of stage B peripheral sinus involvement; C stage4cases, orbital and intracranial invasion. Treatment of6cases: simple operation, operation combined with postoperative radiotherapy in29cases;1underwent lateral rhinotomy combined craniofacial approach,3cases(including1cases with cervical lymph node metastasis of cervical lymph nodedissection), the remaining tumor resection under nasal endoscope. Prognosis:a2year survival rate was85.7%(24/28),3year survival rate was75%(18/24). Apatients3year survival rate was88.2%(15/17); B patients3year survival ratewas75%(12/16); early (A+B)3year survival rate was81.8%(27/33); Cpatients3year survival rate was50%(1/2). By Log-Rank test, early (A+B)and advanced (stage C) survival rate had a significant difference (χ2=4.282,P=0.037). This group of patients there were6cases of recurrence, includingsimple operation recurrence occurred in3cases, operation plus radiotherapy in3cases of recurrence, both for local recurrence, the operation plus radiotherapytreatment again, now survive well, not found in patients with distant metastasis.According to the above analysis, the following conclusions can be drawn:1、300cases of malignant tumor of nasal cavity and sinus: a trend ofyounger age distribution, the overall incidence of men than women, butolfactory neuroblastoma with equal numbers of men and women, adenoidcystic carcinoma and sarcoma incidence in women than in men, the mostprimary paranasal sinuses, and maxillary sinus see more, agree with thosereported in the literatures, olfactory neuroblastoma, lymphoma and sarcoma innasal cavity and paranasal sinus malignant tumors tend to rise gradually.2、35cases of olfactory neuroblastoma diagnosed clearly not easily, easilymisdiagnosed as nasal polyp, clinical on young patients, unilateral nasalobstruction, nasal bleeding, physical examination in the olfactory region ofmiddle turbinate, nasal root top found white or grey and red, crisp rough, easybleeding tumors, combined with paranasal sinus coronal CT and shaft bit slice, consideration should be given to the olfactory neuroblastoma may, preferablypreoperative or intraoperative pathological and newly diagnosed lymph nodeexamination; its characteristic pathological manifestations of typical Flexnerand Homer-Wright rosettes; treatment method with operation therapy andpostoperative radiotherapy best; influence the prognosis of patients with Kadishstage, A, B patients the prognosis is significantly better than C.