Three operation methods in the treatment of nasal inverted papilloma: a randomized controlled study

Objective: To compare the clinical effects between endoscopic sinus surgery,nasal incision and endoscopic Caldwell-Luc surgery in the treatment of nasal inverted papilloma(NIP),and explore the application of three kinds of operations.Methods: One hundred and forty-one NIP patients were randomly divided into the endoscopic sinus surgery group,nasal incision group and endoscopic Caldwell-Luc surgery group using randomized parallel controlled study way.The clinical effects,complications and recurrence rate between the three kinds of operations were analyzed.Results: The differences of the operation time,blood loss and postoperative hospitalization time between three groups were statistically significant(P>0.01).During the following up period,5 cases in endoscopic sinus surgery group,7 cases in nasal incision group and 3 cases in endoscopic Caldwell-Luc surgery group lost to follow.The differences of the total recurrence rate,incidence of complication and total complications in type Ⅰ,Ⅱ and Ⅳ Krouse between three groups were not statistically significant(P>0.05).The differences of the recurrence rates in patients with type Ⅳ Krouse between three groups were statistically significant(P<0.05).The incidences of complication in patients with type Ⅳ Krouse in endoscopic sinus surgery group and nasal incision group were higher than that in endoscopic Caldwell-Luc surgery group(P<0.05).Conclusions: The endoscopic sinus surgery in the treatment of nasal inverted papilloma is short operation time,little bleeding and short hospital stay,which is more suitable for the patients with type Ⅰ to Ⅱ Krouse.The treatment of type Ⅲ Krouse with endoscopic Caldwell-Luc surgery can significantly reduce complications and recurrence rate,the effects of type Ⅳ Krouse patients treated with three kinds operation are not ideal.