Clinical Analysis Of Rhinologic Surgical Procedures For Sinonasal Inverted Papilloma

Object:To investigate the operative effects and selection of surgical procedures in treating sinonasal inverted papilloma (NIP) by comparing the clinical features and selection rules among four different surgical methods.Methods:63patients diagnosised as NIP followed-up at least10months in Department of Otolaryngology-Head and Neck Surgery, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine,during Jan.2002to Feb.2011were reviewed retrospectively. According to the clinical stage of Krouse and Kamel clinical classification standards,there were6cases in stage T1;25cases in stage T2;32cases in stage T3;44cases in type I and19cases in type â…¡.Among these patients,18cases were treated endoscopicallly; and12cases were treated by the lateral rhinotomy(LR);20cases with endoscopic combined caldwell-luc(CL);13cases with endoscopic combined with lateral rhinotomy. Recurrence rate, and blood loss of four different surgical procedures, such as lateral rhinotomy(LR), endoscopic sinus surgery, endoscopic combined caldwell-luc(CL) procedure, and endoscopic combined with lateral rhinotomy, were compared and analysed.Results:The NIP focus could be removed by the four kinds of procedures without serious complications.The average postoperational follow-up period was3.2years. The local recurrence cases in lateral rhinotomy group was25%. The local recurrence cases in endoscopic sinus surgery group was11.1%There were5.0%recurrent cases in endoscopic combined caldwell-luc procedure group. The local recurrence cases in endoscopic combined with lateral rhinotomy group was7.7%.The total recurrence rate of four groups was11.1%. Average amount of blood loss in the nasal endoscopic surgery group were stage T1,80+4.5ml;T2stage113+3.8ml, T3162+5.6ml.The average estimated blood loss during the operations were statistically shorter in the endoscopic group than those in the other three groups(P<0.0001)Conclusions:Four of these procedures are used for treatment of nasal sinus inverted papilloma, Krouse clinical stages as the choice of the ways of standard operation is simple and feasible basis, the clinical classification system of Kamel is important supplement of clinical guidelines.Simple nasal endoscopic surgery is effective in cases of T1and T2stage.Endoscopic combined caldwell-luc procedure and endoscopic combined with lateral rhinotomy are effective in cases of T3stage and type â…¡.