摘要
目的分析上颌窦来源的后鼻孔息肉临床表现及病理特征。方法1998年10月至2004年9月,在施行鼻内镜手术的鼻息肉鼻窦炎患者1023例(1895侧)中,确诊为上颌窦源性后鼻孔息肉46例(4.5%),均为单侧发病,年龄5～65岁,平均15岁,有前期手术史者5例。术后随访1年以上,息肉组织标本经石蜡包埋后切片,光镜下观察病理学特点。结果1年随访治愈率达100%,其中3例局部复发再行鼻内镜下处理治愈。上颌窦源性后鼻孔息肉的临床特点:①单侧发病;②以单侧进行性鼻阻为主诉症状;③儿童多见,多为单个息肉;④息肉均源于上颌窦口窦内侧,蒂部悬于后鼻孔,上颌窦内为一薄壁囊肿,破溃后常有淡黄色液体流出。病理学检查:息肉被覆假复层纤毛柱状上皮,黏膜下炎性细胞浸润,主要为中性粒细胞,嗜酸性细胞浸润较少见,间质水肿,并有潴留囊肿形成,囊肿为单个,较大,内有炎性潴留物。结论上颌窦源性后鼻孔息肉特殊的病理特征及临床表现说明其发病机制可能存在特殊性,临床治疗也应区别对待。依其病理特征诊断为“上颌窦源性后鼻孔囊性息肉”更为确切。
OBJECTIVE To study the clinical and pathological characteristics of antrochoanal polyps. METHODS From Oct. 1998 to Sept. 2004, 1023 cases（1895 sides）of chronic sinusitis and/or nasal polyps were treated with endoscopic sinus surgery. Forty-six patients were diagnosed with antrochoanal polyps; all had a unilateral lesion. The average age of these patients was 15a. The polyps from these patients were fixed in formalin and embedded in paraffin. The sections were cut, stained with HE and observed under light microscope. RESULTS All 46 patients were cured after following up for more than 1 year. The antrochoanal polyps were usually unilateral and appeared in younger patients. The main symptom was nasal obstruction. Macroscopically, they had a cystic intramaxillary portion and a solid intranasal portion. Microscopically, the polyps were covered by pseudostratified ciliated columnar epithelium. The inflammatory cell infiltration in submucous tissue was mainly that of neutrophil cells with few eosinophil cells. Edema and cyst were also found in the submucous tissue. CONCLUSION The pathological findings and clinical features of the antrochoanal polyps indicate that antrochoanal polyps has a different pathogenesis compared with the usual nasal polyps. It should be named antrochoanal cysts rather than antrochoanal polyps.
出处
《中国耳鼻咽喉头颈外科》
北大核心
2006年第4期257-259,共3页
Chinese Archives of Otolaryngology-Head and Neck Surgery
