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乳头状瘤好发于鼻腔、鼻窦、口咽及喉。口咽部的乳头状瘤多发于悬雍垂根部、软腭口腔面及扁桃体表面,呈桑椹状、灰白色或淡红色,基底呈蒂状或广基。但发生于软腭鼻咽面的乳头状瘤较少见,因其部位隐蔽,术前不易发现,就诊时肿瘤范围常较广,给治疗上带来一定的困难。我科1994年11月曾采用软腭翻转术治疗1例软腭鼻咽面乳头状瘤复发的病例,现报告如下。 患者男性,42岁。1982年曾因咽部不适、痰中带血在我院门诊诊断为“软腭鼻咽面乳头状瘤”,并经病理证实。入院后在表麻下采用鼻导管软腭悬吊法暴露肿瘤,于蒂部注入1％奴夫卡因1ml,止血钳卡住蒂部后断离,50％三氯醋酸烧灼蒂根部,术后痊愈出院。患者1年前又感咽部不适,伴痰中带血,于1994年12月再次以“软腭鼻咽面乳头状瘤”入院。入院后纤维鼻咽镜检查见软腭鼻咽面中央有1.8cm×1.8cm大小的肿物。表面呈颗粒状、暗红色。入院后在局麻下行软腭翻转术软腭鼻咽面乳头状瘤切除。病人取仰卧肩高位,常规消毒铺巾处将软腭横形贯穿切开,翻转软腭,暴露肿
Papilloma occurs in the nasal cavity, sinuses, oropharynx and larynx. The papilloma of the oropharynx is mostly deciduous, grayish or reddish, and basally pediculous or broadly basement, usually on the root of the uvula, the surface of the soft palate, and the surface of the tonsils. However, the papilloma that occurs in the soft palate of the nasopharyngeal surface is less common. Because the site is hidden, it is not easy to find it before surgery. The scope of the tumor is often wider at the time of treatment, which brings certain difficulties to the treatment. In November 1994, our department used soft palate reversal to treat 1 case of soft palate recurrent nasopharyngeal papilloma. The report is as follows. Male patient, 42 years old. In 1982, he had been diagnosed as “soft nasopharyngeal papilloma” due to pharyngeal discomfort and sputum blood in our outpatient department. It was confirmed by pathology. After admission, the tumor was exposed under nasal anesthesia using nasal cannula soft palate suspension method. 1 ml of 1% novocarmine was injected into the pedicle. Hemostatic forceps stuck at the pedicle and then was severed. 50% trichloroacetic acid cauterized the pedicle and recovered after surgery. Discharged. The patient felt pharyngeal discomfort 1 year earlier and was accompanied by blood in the sputum. He was admitted to the hospital again in December 1994 with a “soft nasopharyngeal papilloma”. After admission, fiber nasopharyngeal examination showed a 1.8cm x 1.8cm mass in the center of the soft palate. The surface is granular and dark red. After admission, the patient underwent a soft palate incision in the local anesthesia and soft palate resection of the nasopharyngeal papilloma. The patient takes a high position on the back and shoulders. Routinely sterilizes the paillette and cuts the soft palate horizontally. The soft palate is turned over to expose the swelling.