비 · 부비동 종양에 대한 내시경 수술의 응용

Background and Objectives: Endoscopic sinus surgery has been extending its field with the development of surgical devices and powered instruments. Recently endoscopic surgery is applied not only for chronic paranasal sinusitis but also extended to rhinosinus tumors. The purpose of this study is to establish the usefulness of endoscopic surgery in rhinosinus tumors by retrospective analysis of multifactors including pathology, tumor characteristics, surgical options and follow-up results.

Materials and Methods: Forty cases of rhinosinus tumors which were removed by endonasal endoscopic surgery under admission from October 1992 to October 1997 in Pusan National University Hospital were retrospectively reviewed. All tumors were classified benign, intermediate, malignant tumors according to pathological finding and clinical characteristics. Regarding to benign tumors, only solid tumors were included in this study and cystic natured tumors such as mucocele, postoperative maxillary cyst, and antrochonal polyp were excluded. Tumor size, location, vascularity, operative options, operative finding, results of follow-up were analyzed in each tumor.

Results: All benign tumors were sucessfuly removed by endonasal endoscopic surgery except a case developed in the frontal recess and frontal sinus. Thirteen cases of inverted papollomas and four cases of angiofibromas within Session’s stage IIA were also endoscopically excised, showing no recurrence except a case of angio fibroma which was removed by endoscopy again. In four cases of limited malignant tumors, endoscopic surgery had a curative role with postoperative radiation. In two cases, endoscopy could be applied only for diagnosis and mass reduction.

Conclusion: We conclude that benign tumors except tumor occurring in frontal sinus are good indication for endonasal endoscopic surgery. Intermediate tumors such as inverted papilloma and angiofibroma are also good candidate through careful case selection with preoperative workup. However, endoscopy is still limited for surgical curative role in malignant tumors.