內視鏡切除鼻竇及復發性鼻咽惡性腫瘤

Endoscopic Surgery for Malignant Sinonasal and Recurrent Nasopharyngeal Tumors

謝燿光(Yao-Guang Hsieh) ； 陳穆寬(Mu-Kuan Chen)

《The Changhua Journal of Medicine》 9卷s期 (2004/12) Pp. 249-253

摘要

背景及目的：鼻內視鏡手術發展至今已有三十餘年的時間，但對於切除惡性腫瘤方面的應用尚在起步階段，文獻上僅有零星個案被提出，本文發表以內視鏡切除鼻竇和鼻咽惡性腫瘤的治療經驗，以其對此突破性手術做更深入之探討。
方法：從2000年9月1日至2003年8月31日三年間共有5位鼻竇惡性腫瘤和3位復發性鼻咽惡性腫瘤的病患接受內視鏡腫瘤切除手術，其中有一位術後接受放射線治療，所有病患術後皆定期回門診追蹤。
結果：分析此8位病患，無任何手術併發症，病患於術後三天至五天出院，出院後定期門診追蹤，均無局部復發或遠處轉移之情形。
結論：相較傳統鼻竇和鼻咽惡性腫瘤切除手術，內視鏡手術的優點在於無明顯之臉部傷痕，住院天數短，術後疼痛感低。本院之研究成果顯示只要慎選患者，經內視鏡手術亦可為副鼻竇惡性腫瘤及放射治療後復發鼻咽惡性腫瘤之治療方式。

關鍵字

內視鏡手術 ； 鼻竇惡性腫瘤 ； 復發性鼻咽惡性腫瘤

並列摘要

Background and purpose: Although surgeons have been developing the skills for endoscopic nasal sinus surgery for 30 years, use of this technique for excision of malignant sinonasal or recurrent nasopharyngeal tumors began only recently. In this paper, we aim to contribute to the reported experience with this surgery by presenting the clinical cases and treatment courses of 8 patients.
Methods: From September 1, 2000 to August 31, 2003. 8 patients underwent endoscopic tumor excision surgery at the Changhua Christian Hospital. Among them, 5 had malignant sinonasal tumors and 3 had recurrent nasopharyngeal tumors. All had regular follow-up exams after surgery.
Results: No operative complications were noted in any of the 8 patients. All patients were discharged 3 to 5 days after surgery. No local recurrence or distant metastasis has been noted at the follow-up exams.
Conclusion: The advantages of endoscopic sinus surgery compared to traditional methods are the obscure facial scar, shortened hospitalization, and reduced postoperative tenderness. Our experience shows that if patients are well selected, endoscopic surgery is a good surgical alternative for excision of malignant sinonasal and recurrent nasopharyngeal tumors.

並列關鍵字

endoscopic surgery ； malignant sinonasal tumors ； recurrent nasopharyngeal carcinoma