The Clinical Value Of Endoscope Surgery In The Therapy Of The Nasal Inverted Papilloma

Objective and backgroundNasal inverted papilloma (NIP) is a primarily benign lesion that occur in the nasal cavity and paranasal sinuses. Clinical problems include a tendency towards local destrution, recurrence and malignant transformation into squamous cell carcinoma. The surgery treatment has been the first choice for NIP, the principle of the surgery is redical resection. The key points:first, complete resection of tumor and the related nasal cavity and sinus tissue; the second is an en bloc removal of the base of the tumor and the adjacent mucosa and bone. The traditional surgical approach is though the outside nose, which has the disadvantage of facial scar, serious damage, especially the lacking of protection of nasal cavity and paranasal sinuses. Varies of clinical studies show there is no significant difference between outsider nasal approach and endoscopic sinus approach. With the development of the minimally invasive endoscopic technique in recent years, the tumor can be treated by fine surgical anatomy, this approach can be easily accepted by the patients. Objective to evaluate the clinical value of endoscope surgery in the therapy of the nasal inverted papilloma of the three processes through the statistics of the recurrence rate of single endoscope surgery, endoscopic combined with Caldwell-Luc and lateral rhinotomy approach.Methods1 Clinic data:select 43 patients who were treated in the first affiliated hospital of zheng zhou university.2 These cases are registered and retrospectively analyzed. They were operated on by single endoscope surgery, or endoscopic combined with Caldwell-Luc, or lateral rhinotomy approach. Eighteen patients were operated on by single endoscope approach. Fifteen by endoscopic combined with Caldwell-Luc, and ten by lateral rhinotomy approach.The information of recurrence is follow-up visited. Every case is graded by Krouse Method, and the recurrence rate of the three methods of different grades is calculated in tabulation. The average follow-up time is 1.7 year.3 Statistical Analysis SPSS 17.0 software was employed to analyze all date. Statistical evaluation was performed using Chi-Square test. P<0.05 was considered as statistical significance.ResultsThe total recurrence rate is 9.3%. The recurrence rate for single endoscope surergy group I is 11.1%, and the III group is 33.3%. The recurrence rate for lateral rhinotomy approach III is 25.0%, and the group IV is 33.3%. There was no statistically significant difference on the therapeutic effect of three kinds of surgical procedures in same stage. Thirty-seven patients were to be operated on for the first time. Seven patients are for the second time to be operated on. There was no relapse cases after the second surgery.Conclusion1 The single endoscopic surgery is an effective treatment for treating stageⅠ～Ⅱand stage III including OMC,posterior ethmoid,sphenoid sinus. the operating field was clean,no facial incision postoperative lacrimal duct obstruction was markedly decreased, at the same time remaining the local structures and the function of nasal mucosa better.2 Better results for patients in stage III involving maxillary sinus inner wall,lateral wall and floor wall would be achieved by combining endoscopic technique with Caldwell-Luc surgery. Lateral rhinotomy is the firstchoice in stageⅣ. Endoscopy may play a helpful role in lateral rhinotomy.3 The single endoscopic surgery has achieved good effects for recurrence cases.4 Endoscopy is a good approach for early lesion and recurrence cases.