鼻内镜下鼻咽扩大切除术在鼻咽部肿瘤治疗中的应用

郭涛; 孙敬武; 汪银凤; 高炜; 尹飞

doi:10.13201/j.issn.2096-7993.2022.02.008

鼻内镜下鼻咽扩大切除术在鼻咽部肿瘤治疗中的应用

- 中国科学技术大学附属第一医院(安徽省立医院)耳鼻咽喉头颈外科(合肥，230001)

详细信息

通讯作者: 孙敬武，E-mail：entsunjingwu@hotmail.com

中图分类号: R739.63

收稿日期: 2021-10-20

刊出日期: 2022-02-03

Application of endoscopic nasopharyngeal enlargement excision in the surgical treatment of oncology in the nasopharyngeal

- Department of Otolaryngology Head and Neck Surgery, the First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, 230001, China

More Information

Corresponding author: SUN Jingwu, E-mail: entsunjingwu@hotmail.com

Received Date: 20 October 2021

Publish Date: 03 February 2022

摘要

摘要: 目的探讨经鼻内镜下鼻咽扩大切除手术治疗鼻咽部肿瘤的适应证、手术技巧及效果。方法回顾性分析及总结2016年12月—2021年4月经鼻内镜手术治疗的31例鼻咽部良恶性肿瘤患者的临床资料，其中8例良性病变，23例恶性病变，良性病变包括7例鼻咽纤维血管瘤和1例多形性腺瘤，恶性病变包括12例复发的鼻咽癌和11例各种类型鼻咽部恶性肿瘤。所有手术均在鼻内镜下完成。结果所有患者的鼻咽肿瘤均一次性全切，未出现严重手术并发症和后遗症。8例良性肿瘤随访5~49个月，23例恶性肿瘤随访6~58个月。所有良性肿瘤患者均无复发; 1例骨肉瘤患者术后8个月复发，予以再次鼻内镜下手术治疗，并辅助化疗; 1例鼻咽癌患者术后2年复发，予2次鼻内镜下手术，术后均予化疗，仍在随访中; 其余随访无复发。结论对于鼻咽良恶性肿瘤，鼻内镜下鼻咽扩大切除术可以依靠解剖标志辨认安全彻底切除肿瘤。术中要充分暴露肿瘤和视野，保护重要的结构。
- 鼻咽肿瘤 /
- 内镜外科治疗
Abstract: Objective To evaluate the clinical indication, technique, effect and cautions of intranasal endoscopic surgery for nasopharyngeal tumor.Methods Between December 2016 and April 2021, 31 patients who received endoscopic nasopharyngectomy for nasopharyngeal tumors were analyzed retrospectively, 8 benign and 23 malignant cases were included. 8 benign cases included 7 cases with nasopharyngeal fiber hemangioma and 1 case with polymorphic adenoma. Twenty-three malignant cases included 12 cases with recurrent nasopharyngeal carcinoma after chemoradiotherapy and 11 cases with various types of malignancies. All patients underwent endoscopic resection of nasopharyngeal tumors through bilateral transnasal approach.Results Total resection of the tumor was achieved for all cases without severe surgical complications. 8 cases with benign tumors, with following-up of 5-49 months, showed no recurrence. 23 cases with malignant tumors, with following-up of 6-58 months, 22 cases show no recurrence, 1 recurent nasopharyngeal osteosarcoma, curved after another operation and assisted with chemotherapy, 1 case with nasopharyngeal carcinoma survived with disease after two endoscopic operations.Conclusion Nasopharyngeal tumor could be completely resected with endonasal endoscopic surgery according to the anatomic structure. Surgery should provide a panoramic view on nasopharyngeal cavity and tumors, protect important structures.
- nasopharyngeal neoplasms /
- endoscopic surgical procedures

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图 1 例1患者CT检查

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图 7 例2患者CT检查

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