The Clinical Effect Of Different Surgical Therapy For Nasal Inverted Papilloma

Background and objective nasal inverted papillomas(NIP)originally have a benign entity but they can have the different biological characteristics of benign tumors :a high potential of recurrence(be up to 78%),risk of malignancy(malignant transformation rate from 5% to 15%),locally aggressive.Accurate identification of the attachment site and Scope of infringement,determine the scope of the resection,radical resection are the most effective treatment for the NIP.By analyzing the 133 cases of nasal inverted papilloma(NIP),we get the description of general clinical features.According to Krouse’s classification and clinical efficacy of the three different NIP curing operation methods(pure endoscopic surgery,endoscope combined with Caldwell-Luc surgery,the traditional lateral rhinotomy surgery),we discuss both the clinical value of nasal endoscopic treatment in curing NIP and the reference value of surgical treatment in the choice of NIP operation methods.Method We analyzed retrospectively the 133 NIP operation profiles that were treated in the department of otolaryngology of xx,and assign the NIP patients into different groups according to Krouse’s classification and their operation methods.We counted and analyzed the patients’ data of operation duration(min),bleeding amount(ml),duration of hospital stays(d)and the relapse rate.Statistical analyses were performed using SPSS 17.0.The the Fisher’s exact test and T test was applied when appropriate to evaluate the statistical significance.p <0.05 was regarded as statistically significant。Results The operation duration of pure Endoscopic surgery(59.40±17.124min)is significantly shorter than that of nasal endoscope joint Caldwell-Luc operation(88.23±13.877min)and the traditional lateral rhinotomy operation(95.56± 12.429min),and P<0.05,making statistical significance.The operation duration of nasal endoscope joint Caldwell-Luc operation(88.23±13.877min)is significantly shorter than that of traditional lateral rhinotomy operation(95.56± 12.429min),and P<0.05,making statistical significance.The bleeding amount stays of pure Endoscopic surgery(50.80± 32.362ml)is significantly shorter than that of nasal endoscope joint Caldwell-Luc operation(102.58± 34.007ml)and the traditional lateral rhinotomy operation(110.00 ±33.050ml),and P<0.05,making statistical significance.The duration of hospital stays of pure Endoscopic surgery(8.95 ±2.399 d)is significantly shorter than that of nasal endoscope joint Caldwell-Luc operation(10.68± 2.166d)and the traditional lateral rhinotomy operation(12.52± 2.651d),and P<0.05,making statistical significance.The duration of hospital stays of nasal endoscope joint Caldwell-Luc operation(10.68± 2.166d)is significantly shorter than that of traditional lateral rhinotomy operation(12.52± 2.651d),and P<0.05,making statistical significance.The Nasal endoscopic treatment Group: According to Krouse’s classification,there are 6 palindromia among the total 40 cases of Ⅰstage,the relapse rate is 15%;there are 3 palindromia among the total 20 cases of Ⅱ stage,the relapse rate is 15%;there are 4 palindromia among the total 15 cases of Ⅲ stage,the relapse rate is 26.67%;The nasal endoscope joint Caldwell-Luc operation treatment Group: there are 3 palindromia among the total 10 cases of Ⅱ stage,the relapse rate is 30%;there are 4 palindromia among the total 21 cases of Ⅲ stage,the relapse rate is19.05%;the traditional lateral rhinotomy operation Group: there are 1 palindromia among the total 3 cases of Ⅰstage,the relapse rate is 33.33%;there are 4 palindromia among the total 10 cases of Ⅱ stage,the relapse rate is 40%;there are 5 palindromia among the total 14 cases of Ⅲ stage,the relapse rate is 35.71%;the total relapse rate is 22.56%The clinical classifications are the same among the three different NIP treatments.And there is no significant statistical difference in comparing the relapse rate of different operation methods.Conclusion The operation duration(min),bleeding amount(ml),duration of hospital stays of Nasal endoscopic are much lower than that of the other two groups,confirming that Nasal endoscopic has clear Imaging function.The total relapse rate is 22.5%,the clinical classifications are the same among the three different NIP treatments.And there is no significant statistical difference in comparing the relapse rate of different operation methods.Pure Endoscopic surgery for Krouse’s Ⅰ and Ⅱ classification,has a good therapeutic effect,the relapse rate is 15%。 When The tumor involves the lateral,inferior,or anterior wall of the maxillary sinus,nasal endoscope joint Caldwell-Luc operation is a better treatment to reduce relapse rate.