目的:内翻性乳头状瘤(IP)是鼻腔最常见的良性肿瘤,已知有复发风险。没有标准化的方法来确定附着部位的治疗。本系统评价旨在确定外科医生对技术的选择是否因解剖附着部位而异,以及不同的手术技术是否有助于降低复发率。
方法:PubMed和OvidMedline。
方法:对报告IP的研究进行了系统评价。对包括IP复发率和原发肿瘤附着部位的患者进行了综述。
结果:在已发表的122项研究中,14符合资格标准,代表585例患者,复发率为5.8%。上颌窦(50.9%)是最常见的主要附着部位,蝶窦的复发率最高(10.4%)。最常用的技术包括切除肿瘤,去除附着部位的粘膜,钻下面的骨头。最常见的Krouse阶段为T3(53.3%)。没有一种技术能预测复发的倾向,但某些技术是有利的取决于IP连接站点。最后,冷冻切片以获得清晰切缘的证据,术中复发率显着降低(3.4%vs7.3%,P=.045)。
结论:根据现有文献,解决附着部位的最常见技术包括切除粘膜和钻孔肿瘤基底。对于不同的附着部位,技术的选择似乎有所不同。术中冰冻切片分析的使用似乎与总体复发率降低有关。
方法:3.
OBJECTIVE: Inverted papilloma (IP) is the most common benign neoplasm of the nasal cavity with known risk of recurrence. There is no standardized approach to definitive treatment for attachment sites. This systematic
review aims to determine whether surgeon choice of technique differs by anatomic attachment site and whether different surgical techniques contribute to reduced rates of recurrence.
METHODS: PubMed and Ovid Medline.
METHODS: A systematic
review was conducted for studies reporting on IP. Those that included IP recurrence rates and primary tumor attachment site were reviewed.
RESULTS: Of 122 published studies, 14 met eligibility criteria, representing 585 patients and a recurrence rate of 5.8%. The maxillary sinus (50.9%) was the most common primary attachment site, and the sphenoid sinus was associated with the highest rate of recurrence (10.4%). The most utilized technique included debulking the tumor, removing mucosa over the attachment site, and drilling the underlying bone. The most common Krouse stage represented was T3 (53.3%). No single technique predicted a propensity for recurrence, but certain techniques are favored depending on IP attachment site. Finally, frozen sections to obtain evidence of clear margins intraoperatively significantly reduced rates of recurrence (3.4% vs 7.3%, P = .045).
CONCLUSIONS: Based on the current literature, the most common technique to address site of attachment involves resecting mucosa and drilling the tumor base. Choice of technique appears to differ for various sites of attachment. Use of intraoperative frozen section analysis appears to be associated with decreased recurrence overall.
METHODS: 3.