The Efficacy Analysis of Different Operative Methods in Sinonasal Inverted Papilloma

Objective To evaluate the therapeutic effects of surgery on inverting papilloma in nasal cavity and paranasal sinus among three kinds of surgical procedures,So as to provide basis for the correcttly choosing operation method.Methods Clinical information of 219 patients with sinonasal inverted papiloma treated surgically were retrospectively reviewed.According to Krouse classification,There were 30 cases in stage I;85 cases in stage II;84 cases in stage 11I and 20 cases in stage IV.Among these patients,102 cases were treated endoscopically(nasal endoscopic surgery group);93 cases were treated by endoscopic excision combined with Caldwell-Luc procedure(endoscopic excision combined with Caldwell-Luc surgery group);24 cases underwent lateral rhinotomy(nasal lateral incision group).All patients were followed up 5 months ~ 8 years(average 3.5 years).Postoperative recurrence rate,complications and peri-operative bleeding of three kinds of surgeries were compared.Results Recurrence rate of III stage patients was significantly higher in nasal endoscopic surgery group that that in endoscopic excision combined with Caldwell-Luc surgery group(P0.05).Recurrence rate of II and IV stage patients was significantly lower in nasal endoscopic surgery group that that in nasal lateral incision group(P0.05).Incidence of omplications showed significant difference among different surgeries(P0.05).Comparing nasal endoscopic surgery group and nasal lateral incision group,complication incidence of II stage patients was significant difference(P0.05);comparing endoscopic excision combined with Caldwell-Luc surgery group and nasal lateral incision group,complication incidence of II stage patients was significant difference(P0.05);The volume of bleeding during surgery in nasal endoscopic surgery group was significantly lower than that in nasal lateral incision group(P0.01).Conclusion The nasal endoscopy was a better method for treating Ⅰ~Ⅱstage nasal inverted papilloma.Better choice for patients in stage III should be combining endoscopic technique with Caldwel1-Luc procedure.