The Clinical Study Of Midfacial Diglove Operation In Nasal Tumor

PART 1 :THE CLINICAL STUDY OF MIDFACIAL DEGLOVE OPERATION IN THE TREATMENT OF BENIGN TUMOR IN RHINOLOGYObjective: To evaluate the therapeutic effect of the midfacial deglove operation on benign tumor in rhinology.Clinical information: 57patients(male:41cases, female:16cases) with benign tumor in rhinology, who underwent midfacial deglove operation from 1998 to 2006 in QiLu hospital of ShanDong university were summarized. The mean age was 35.4 years (range 9 to 65). The principal part of benign lesions were inverted papilloma of nasal cavity and sinuses (26 cases) and nasopharyngeal fibrohemangioma (18 cases), the rest were bleeding necrosis nasal polyps (8 cases), adenoma of maxillary sinus(2 cases), osteoma of maxilla (2 cases), meningioma (1 case).Prognosis: The incisions of all patients healed on time. the functions of respirtion, deglutition, phonation were normal after the operations without exception. 2 cases of the 26 patients who had suffered inverted papilloma relapsed from 1 year to 1.5 year after the operation, the 2 cases were treated by intranasal endoscopic surgery and there was no relapse in the following 2 years. In the 18 patients who had suffered nasopharyngeal fibrohemangioma, the operation method of 1 case was changed during the operation, 1 case had residual carcinoma at one lateral of sphenoid sinus and 1case had facial hematoma postoperatively. 3 cases relapsed from10 monthes to 5 years after the operation and thy treated withfurther surgery.Conclusion:The midfacial deglove operation is an alternativeapproach for the treatment of benign tumor in rhinology . It hasgood value of clinical application if using it properly. PART 2:THE CLINICAL STUDY OF MIDFACIAL DEGLOVE OPERATION IN THE TREATMENT OF MALIGNAT TUMOR INRHINOLOGYObjective: To evaluate the therapeutic effect of the midfacial deglove operation on malignant tumor in rhinology.Clinical information: 45patients(male:28cases,female:17cases) with malignant tumor in the nasal cavity and paranasal sinuses who underwent midfacial deglove operation from 1998 to 2006 in QiLu hospital of ShanDong university were summarized. The mean age was 56.3 years (range 41 to 72). According to the TNM staging system(UICC,1997): T₁N₀M₀6 cases, T₂N₀M₀10 cases, T₃N₀M₀13 cases, T₄N₀M₀11 cases, T₃N₁M₀5 cases. There were 39 cases in stage 2-3 of the malignant tumor in the nasal cavity and paranasal sinuses. 27 casese were treated by midfacial deglove operation and maxillectomy;13 casese were treated by midfacial deglove operation,maxillectomy and resection of the eye ball; 5 cases were treated by midfacial deglove operation through cranifacial approaches. Neck dissection was performed in the 5 patients who were in the stage T₃N₁M₀.Prognosis: The functions of respirtion,deglutition,phonation were normal after the operations without exception. The incisions of 44 patients healed on time. the incision of one 70-year-old patient healed with more time .The 5-years living ratio of the 45 cases is 28.9% (13/45), the rata of stage T₁/T₂ is 43. 7% (7/16), the rate of stage T₃/T₄ is 20.7% (6/29) .Conclusion:The midfacial deglove operation is an alternative approach for the treatment of malignant tumor in the nasal cavity and paranasal sinuses. Comparing with the traditional opration, the midfacial deglove operation has some advantages for the treatment of malignant tumor in the nasal cavity and paranasal inuses:â‘ It can offer broad vision of the operation field, expose the operation field clearly and shorten the length of operation. We can deal with the lesion of the both sides with this operation and we can use the modified operation to treat the lesion in single side;â‘¡The facial tissue can get enough blood and nutrition, so the patient can recover smoothly. There is no scar on face , it can be accepted by patient.â‘¢According to different condition, we can combine it with other operations such as maxillectomy,resection of the eye ball,intranasal endoscopic surgery,intracranial operation and so on. The midfacial deglove operation can be used broadly in clinical treatment.