上海交通大学耳鼻咽喉科学英文版课件 tumor of nasal cavity and paranasal sinuses.ppt

Tumor of Nasal cavity and Paranasal sinuses Department of Otolaryngology, Affiliated Ninth People’ s Hospital of Shanghai Jiaotong University, School of Medicine Wang Peihua  Benign Tumor of Nasal cavity and Paranasal sinuses Papilloma （p107) etiology unknown human papilloma virus, HPV Pathology: Hard type 1 small, hard, gray, local, single, mulberry-shaped 2 usually located in nasal vestibule, anterior nasal septum, hard palate 3 squamous epithelium Soft type comparatively large, soft, red, diffuse growth, with pedicle/wide base. Schneiderian membrane Inverting papilloma ①recurrent tendency ②malignant change ③multiple growth and histoclasia Clinical manifestation 40y, malefemale Unilateral Persistent, progressive nasal obstruction mucopurulent discharge, sometimes with blood Headache and dysosmia Rhinosinusitis and nasal polyps Examination with different size and hardness, Polypoid, red-gray, scobinate, easy-bleeding, usually located in nasal wall. Treatment radical resection lateral rhinotomy/ sublabrum approach, Maxillectomy+ ethmoidotomy( if necessary) Endoscopic Sinus Surgery. Malignant Tumor of Nasal cavity and Paranasal sinuses （p109） Statistics: ENT: 20% in total Malignant Tumor. Nasal and sinonasal MT: 21.74%--49.22% in ENT MT. Male: female =3∶1，predilection age: 40～60y. Features: predilection site is maxillary sinus(60～80%), 1/3 with ethmoid sinus MT. ethmoid sinusfrontal sinussphenoid sinus. primary tumormetastatic tumor. advanced stage primary stage invasion of adjacent tissue( orbit, skull base) Etiological factor Immunocompromice Stimulation of chronic inflammation Canceration of benign tumor Exposure to oncogens Pathology SCC(35%-66%)，other: adenocarcinoma( only in paranasal sinuses), lymphoepithelial carcinoma, transitional epithelioma, BCC, sarcoma. Carcinoma Sarcoma( 3.5-9.6 : 1). Most of sarcoma is malignant lymphoma(60%). clinical manifestation 1．Nasal obstruction 2．Epistaxis or hemic secretion Ca