摘要
背景；原發於鼻腔及副鼻竇之惡性腫瘤於臨床上並不多見，而且於診斷確定時多屬晚期，於後常不盡人意。本報告的目的乃針對原發性鼻腔及副鼻竇之惡性腫瘤就其臨床病程、細胞組織型態及治療方法與結果，作一回朔性的探討。 方法；本報告收及1985年8月至1997年11月間，至本科住院治療之鼻腔及副鼻竇之惡性腫瘤病例，就病歷記載，採取回朔性分析，包括病人之年紀、性別、初期症狀、病理組織切片報告、臨床分期、治療方法與結果及存活率等。 結果；剔除無法追蹤病程者7名，或原發部位不確定者3名，本報告共探討33個病例，男性23例，女性10例，年齡從31到76歲不等，平均年齡54歲。臨床分期第Ι期: 1例、第I I 期；11例、第III期例、第IV期;10例。初期表現以單側鼻塞、流鼻血、鼻漏或臉頰腫脹較多。細胞組織型態以麟狀尚皮細胞癌及未分化之上皮細胞癌為大宗。治療方法已手術合併放射線治療為主。最終有7例合併遠端轉移。治療後早期(I&II)及晚期(III&IV)病例之五年存活率分別為63.6% 及46.7%，而整體之五年存活率為53.8% 結論；原發於鼻腔及副竇癌之惡性腫瘤於臨床上並不多見，初期表現以單側鼻塞、流鼻血、鼻漏或臉頰腫脹較多，因為初期症狀有實與鼻竇炎不易區分，故臨床上常被病人誤以為是單純鼻竇炎而延誤治療時機。本研究中的治療方法已手術合併放射線治療為主，對於較晚期的病患則合併化學治療，但整體而言，治療效果仍不令人滿意。因此，對於鼻腔及副竇之惡性腫瘤，如何早期建立正確診斷並提供適當的治療方法，仍是一個直得深入探討的問題。(中耳醫治 200: 35:236-241)
並列摘要
BACKGROUUND; Sinonasal malignancies comprise less than 1% of all cancers in most series. In this stud we retrospectively reviewed out clinincal data relating these rare malingnancies to better understand their clinical characteristics. METHODS; the medical records of 48 patients with sinonasal malignancies were reviewed. The clinical features. Initial presentations. Tumor histologv. Treatment madali-ties and outcomes of treatment were analyzed. RESULTS;Of the 33 cases enrolled in this study, 23 were men and 10 were women with ages ranging from 31 to 76(mean 54). One patient had stage I tumor. Eleven patients stag II, eleven patients stage III, and ten patients stage IV. The most common initial presentations were unilateral nasal obstruction(61%) and epistaxis(61%), followed by orbital symptoms, facial swelling and rhinorrhea. Histoligically, squamous cell carci-noma(43%) and undifferentiated carcinoma(33%) accounted for most of the tumors. Approriate treatment typically comprised surgical resection combined with radiother-apy. The overall 5-tear survival rate was 53.8%, a figure comparable to previous reports. CONCLUSIONS;Sinonasal malignancies are rare They are often indistinguishable from benjgn lesions or inflammatory disorders of the sinuses at initial presentation, which may lead to a delay in accurate dignosis and treatment, It this study, the most common treat-mcnt of choice was a combination of surgical rcsccion and radiotherzady. Early diagnosis and timely treatment are critical to sinonasal malingnancies management strategies seeking to minimize morbidity and mortality