Endonazal endoskopik inverted papillom cerrahisinde uludağ deneyimi
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Date
2020-04-01
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Bursa Uludağ Üniversitesi
Abstract
Bu çalışmada sinonazal bölgenin en sık opere edilen benign tümörü olan invertedpapillom(İP) tanısı ile endonazal endoskopik cerrahi uygulanan hastalarda klinik sonuçların ve rekürrens ile tümör evresi arasında ilişki olup olmadığının belirlenmesi amaçlanmıştır. Bu retrospektif çalışmada üçüncü basamak hizmet veren bir üniversite hastanesinin KBB anabilim dalında 2005 ile 2019 yılları arasında İP tanısı ile endoskopik cerrahi uygulanmış ve çalışma kriterlerine uyan 75 hastanın tıbbi verileri değerlendirilmiştir. Hastaların demografik verileri, primer semptomları, ameliyat öncesi görüntülemeleri, ameliyat notları, tümör evreleri ile takipte gelişen rekürrens ve malign transformasyon oranları tespit edildi. Tümör evresi ile nüks arasında ilişki olup olmadığı istatistiksel olarak hesaplandı. 50 hastaya primer cerrahi ve 25 hastaya ise rekürren cerrahi uygulandığı görüldü. Hastaların tümör evreleri; T1 (n:11, %14), T2 (n:39, %52), T3 (n:16, %21) ve T4 (n:9, %12) olarak bulundu. Tümörün en sık yerleştiği bölgeler, 52 hastada lateral nazal duvar-maksillersinüs medial duvarı ve 28 hastada etmoid hücrelerdi. Takip süresinde 4 hastada (%5) skuamöz hücreli kansere dönüşüm izlendi. Nüks gelişmesi oranları ile tümör evresi arasında anlamlı (p<0.001) ilişki saptandı; T1: 1/11 (%0,9), T2: 7/39 (%18), T3: 9/16 (%56) ve T4:8/9 (%88). Endoskopik endonazal cerrahi ile İP tedavisinde son yıllarda çok başarılı sonuçlar elde edilmektedir. Ancak effektif cerrahilere rağmen bu tümörlerde rekürrens veya malign transformasyon riski halen yüksektir. Bu nedenle cerrahi sonrası endoskopik ve görüntüleme yöntemleri ile düzenli takipler yapılması mutlak gerekliliktir.
In this study, we aimed to evaluate the clinical outcomes and the relation between tumour stage and recurrence rates in patients who underwent endonasal endoscopic surgery with the diagnosis of inverted papilloma (IP)-the most common operated benign tumour of sinonasal region. The medical records of 75 patients who complied the inclusion criteria and underwent endoscopic surgery with diagnosis of IP between the years 2005 and 2019 at the ENT department of a tertiary university hospital were enrolled in this study. The demographic data of the patients, primary symptoms, preoperative imagings, operation notes, tumour stages and recurrence or malign transformation rates during follow-up were all documented. The relation between tumour stages and recurrence rates were calculated. We performed primary surgery in 50 patients and recurrent surgery for relapses in 25 patients. The tumor stages of patients were found as; T1 (n:11, 14%), T2 (n:39, 52%), T3 (n:16, 21%) and T4 (n:9, 12%). The most common locations of tumour were found as; lateral nasal wall-medial wall of maxillary sinus in 52 patients and ethmoid cells in 28 patients. In four patients (5%) malignant transformation was observed during follow-up. There was significant relation (p<0.001) between recurrence rates and tumour stages as; T1: 1/11 (9%), T2: 7/39 (18%), T3: 9/16 (56%) ve T4:8/9 (88%) relatively.
In this study, we aimed to evaluate the clinical outcomes and the relation between tumour stage and recurrence rates in patients who underwent endonasal endoscopic surgery with the diagnosis of inverted papilloma (IP)-the most common operated benign tumour of sinonasal region. The medical records of 75 patients who complied the inclusion criteria and underwent endoscopic surgery with diagnosis of IP between the years 2005 and 2019 at the ENT department of a tertiary university hospital were enrolled in this study. The demographic data of the patients, primary symptoms, preoperative imagings, operation notes, tumour stages and recurrence or malign transformation rates during follow-up were all documented. The relation between tumour stages and recurrence rates were calculated. We performed primary surgery in 50 patients and recurrent surgery for relapses in 25 patients. The tumor stages of patients were found as; T1 (n:11, 14%), T2 (n:39, 52%), T3 (n:16, 21%) and T4 (n:9, 12%). The most common locations of tumour were found as; lateral nasal wall-medial wall of maxillary sinus in 52 patients and ethmoid cells in 28 patients. In four patients (5%) malignant transformation was observed during follow-up. There was significant relation (p<0.001) between recurrence rates and tumour stages as; T1: 1/11 (9%), T2: 7/39 (18%), T3: 9/16 (56%) ve T4:8/9 (88%) relatively.
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Keywords
Benignparanazal tümör, İnvertedpapillom, Rekürrens, Endoskopik cerrahi, Malign transformasyon, Inverted papilloma, Endoscopic surgery, Benign paranasal tumour, Recurrence, Malignant transformation
Citation
Demir, U. L. (2020). ''Endonazal endoskopik inverted papillom cerrahisinde uludağ deneyimi''. Uludağ Üniversitesi Tıp Fakültesi Dergisi, 46(1), 53-57.