鼻腔inverted papillomaの治療法

Surgical Treatment for the Inverted Papilloma of the Nose

I．はじめに

　鼻腔に発生するinverted papillomaに関する報告は内外を問わず数多くみられ，論点は①悪性像を伴うあるいは悪性化するものがあること，②高い頻度で再発すること，の2点に集約される。

　悪性像あるいは悪性化の診断は術前の生検，術中の迅速診断，術後の摘出標本の検索などで病理医に委ねるべき事項であり，悪性像が確認されれば癌としての治療が必要になる。

It is well known that inverted papilloma of the nose showed a high incidental relapse and malignant change. The many previous authors emphasized the necessity of radical surgical pro-cedures. In this paper, we presented 9 cases of inverted papilloma of the nose and discussed the indication and limitation of transantral approach.

The rhinoscopic findings played an important role, and when the middle turbinate seemed free from the disease, the ethmoid sinus was almost free from the disease, so the tumor was removed completely through the transantral approach. However, when the middle turbinate was affected, the tumor involved the ethmoid sinus deeply. Therefore, lateral rhinotomy and medial maxillec-tomy should be performed.