Nghiên cứu đặc điểm lâm sàng, cận lâm sàng và đánh giá kết quả sau 3 tháng phẫu thuật nội soi u nhú mũi xoang có sử dụng IGS

B GIO DC V O TO B Y T TRNG I HC Y H NI THN HU TIP Nghiên cứu đặc điểm lâm sàng, cận lâm sàng đánh giá kết sau tháng phẫu thuật nội soi u nhú mũi xoang có sử dụng IGS Chuyờn ngnh : Tai Mi Hng Mó s : NT 62725301 LUN VN TT NGHIP BC S NI TR Ngi hng dn khoa hc: TS Nguyn Quang Trung H NI - 2015 LI CM N hon thnh lun ny tụi xin by t lũng kớnh trng v s bit n sõu sc ti: TS Nguyn Quang Trung, Ging viờn B mụn Tai Mi Hng Trng i hc Y H Ni Thy ó truyn t cho tụi nhng kin thc, kinh nghim quý bỏu hc v l thy trc tip hng dn tụi hon thnh lun ny Tụi xin chõn thnh cm n: - Ban Giỏm hiu, Phũng o to Sau i hc, B mụn Tai Mi Hng Trng i hc Y H Ni - Ban Giỏm c, Phũng K hoch tng hp, th y bỏc s Khoa Ung bu B1 - Bnh vin Tai Mi Hng Trung ng ó quan tõm, giỳp v to iu kin thun li nht cho tụi sut quỏ trỡnh hc cng nh hon thnh lun Cui cựng tụi xin gi li tri õn ti gia ỡnh, bn bố, ng nghip v tt c nhng ngi thõn yờu nht ó luụn ng viờn, chia s v giỳp tụi sut thi gian qua H Ni, ngy 24/11/2015 Thõn Hu Tip LI CAM OAN Tụi xin cam oan, õy l cụng trỡnh nghiờn cu ca riờng tụi, cỏc s liu ghi lun ỏn l trung thc v cha tng cụng b bt k cụng trỡnh no khỏc H Ni, ngy 24/11/2015 Thõn Hu Tip CC CH VIT TT BN : Bnh nhõn CLVT .: Ct lp vi tớnh CT : Computed tomography HPV : Human papillomavirus IGNS .: Image-guided navigation system IGS : Image-guided system MRI : Magnetic Resonance Imaging MSCT .: Multislice Computed Tomography PET-CT .: Positron Emission Tomography - Computed Tomography PHLN .: Phc hp l ngỏch PT : Phu thut PTNS : Phu thut ni soi PTNSMX : Phu thut ni soi mi xoang PTV : Phu thut viờn UNN : U nhỳ o ngc UNMX : U nhỳ mi xoang MC LC T VN Error! Bookmark not defined Chng 1: TNG QUAN TI LIU Error! Bookmark not defined 1.1 LCH S NGHIấN CU U NH MI XOANG Error! Bookmark not defined 1.1.1 Th gii Error! Bookmark not defined 1.1.2 Vit Nam Error! Bookmark not defined 1.2 GII PHU NG DNG NI SOI MI XOANG Error! Bookmark not defined 1.2.1 Gii phu hc mi Error! Bookmark not defined 1.2.2 Gii phu cỏc xoang cnh mi .Error! Bookmark not defined 1.3 C IM CU TO NIấM MC MI XOANG: Error! Bookmark not defined 1.4 BNH HC U NH MI XOANG Error! Bookmark not defined 1.4.1 Dch t hc lõm sng .Error! Bookmark not defined 1.4.2 Bnh sinh u nhỳ mi xoang Error! Bookmark not defined 1.4.3 c im lõm sng Error! Bookmark not defined 1.4.4 c im chp CLVT u nhỳ mi xoang Error! Bookmark not defined 1.4.5 c im mụ bnh hc Error! Bookmark not defined 1.4.6 Chn oỏn u nhỳ mi xoang Error! Bookmark not defined 1.5 IU TR U NH MI XOANG Error! Bookmark not defined 1.5.1 Cỏc phng phỏp iu tr u nhỳ mi xoang Error! Bookmark not defined 1.5.2 Phu thut ni soi iu tr u nhỳ mi xoang Error! Bookmark not defined 1.6 H THNG HNG DN HèNH NH NH V Error! Bookmark not defined 1.6.1 Cu to ca h thng IGS Error! Bookmark not defined 1.6.2 Nguyờn tc tỏi to hỡnh nh ng dng vo IGS Error! Bookmark not defined 1.6.3 Nhng ng dng hin ca IGS PTNSMXError! Bookmark not defined Chng 2: I TNG V PHNG PHP NGHIấN CU Error! Bookmark not defined 2.1 I TNG NGHIấN CU Error! Bookmark not defined 2.1.1 Tiờu chun la chn Error! Bookmark not defined 2.1.2 Tiờu chun loi tr Error! Bookmark not defined 2.2 PHNG PHP NGHIấN CU Error! Bookmark not defined 2.2.1 Thit k nghiờn cu .Error! Bookmark not defined 2.2.2 Phng phỏp chn mu .Error! Bookmark not defined 2.2.3 Phng tin nghiờn cu Error! Bookmark not defined 2.2.4 Cỏc bc tin hnh nghiờn cu Error! Bookmark not defined 2.2.5 Ni dung nghiờn cu .Error! Bookmark not defined 2.2.6 X lý v phõn tớch s liu .Error! Bookmark not defined 2.3 O DC NGHIEN CU Error! Bookmark not defined Chng 3: KT QU NGHIấN CU Error! Bookmark not defined 3.1 C IM LM SNG, CLVT V Mễ BNH HC CA U NH MI XOANG Error! Bookmark not defined 3.1.1 c im lõm sng Error! Bookmark not defined 3.1.2 c im u nhỳ mi xoang trờn phim MSCT Error! Bookmark not defined 3.1.3 c im mụ bnh hc Error! Bookmark not defined 3.2 NH GI KT QU SAU THNG PHU THUT NI SOI U NH MI XOANG Cể S DNG IGS Error! Bookmark not defined 3.2.1 iu tr phu thut u nhỳ mi xoang cú s dng IGS Error! Bookmark not defined 3.2.2 Bin chng v di chng ca phu thut Error! Bookmark not defined 3.2.3 Kt qu sau phu thut v tỏi phỏt Error! Bookmark not defined Chng 4: BN LUN Error! Bookmark not defined 4.1 C IM LM SNG, MSCT V Mễ BNH HC Error! Bookmark not defined 4.1.1 c im lõm sng Error! Bookmark not defined 4.1.2 c im ca u nhỳ mi xoang trờn phim MSCT Error! Bookmark not defined 4.1.3 c im mụ bnh hc Error! Bookmark not defined 4.2 NH GI KT QU SAU THNG PHU THUT NI SOI UNMX Cể S DNG H THNG HNG DN HèNH NH NH V Error! Bookmark not defined 4.2.1 iu tr phu thut u nhỳ mi xoang cú s dng IGS Error! Bookmark not defined 4.2.2 Bin chng v di chng Error! Bookmark not defined 4.2.3 Kt qu sau phu thut v tỏi phỏt Error! Bookmark not defined KT LUN Error! Bookmark not defined KIN NGH Error! Bookmark not defined TI LIU THAM KHO PH LC DANH MC BNG Bng 3.1 Phõn b nhúm tui ca bnh nhõn nghiờn cu Error! Bookmark Bng 3.2 not defined Thi gian din bin bnh cho ti vo vin Error! Bookmark Bng 3.3 not defined V trớ xut phỏt UNMX xỏc nh phu thut Error! Bng 3.4 Bookmark not defined Cỏc c im tn thng trờn MSCT Error! Bookmark not Bng 3.5 defined V trớ tn thng trờn phim MSCT i chiu vi giai on Krouse Bng 3.6 Error! Bookmark not defined Chn oỏn giai on UNMX PTNS Error! Bookmark not Bng 3.7 defined i chiu giai on trờn CLVT v PTNS Error! Bookmark Bng 3.8 not defined i chiu tn thng cỏc xoang trờn MSCT v PT Error! Bng 3.9 Bookmark not defined Tỡnh hỡnh phu thut mi xoang ca bnh nhõn Error! Bookmark not defined Bng 3.10 Loi phu thut ni soi Error! Bookmark not defined Bng 3.11 i chiu giai on phu thut vi ng phu thut Error! Bookmark not defined Bng 3.12 Cỏc v trớ s dng nh v phu thut Error! Bookmark not defined Bng 3.13 i chiu v trớ s dng nh v vi loi phu thut Error! Bookmark not defined Bng 3.14 i chiu v trớ s dng nh v vi giai on UNMX Error! Bookmark not defined Bng 3.15 Bin chng phu thut Error! Bookmark not defined Bng 3.16 T l bin chng sau m v di chng Error! Bookmark not defined Biu 3.17 Triu chng c nng ca bnh nhõn Error! Bookmark not defined Bng 3.18 ỏnh giỏ phu thut theo khỏm ni soi sau m Error! Bookmark not defined Bng 3.19 Kt qu phu thut qua khỏm ni soi theo loi phu thut Error! Bookmark not defined Bng 3.20 Tỏi phỏt ca bnh nhõn nghiờn cu Error! Bookmark not defined Bng 3.21 V trớ tỏi phỏt u sau PTNS Error! Bookmark not defined Bng 3.22 V trớ tỏi phỏt u sau phu thut vi v trớ xut phỏt u Error! Bookmark not defined Bng 3.23 T l tỏi phỏt theo ng phu thut Error! Bookmark not defined Bng 3.24 T l tỏi phỏt theo giai on u PTNS Error! Bookmark not defined DANH MC BIU Biu 3.1 Phõn b bnh nhõn nghiờn cu theo gii tớnh Error! Bookmark not defined Biu 3.2 Lý vo vin ca bnh nhõn nghiờn cu Error! Bookmark not defined Biu 3.3 Triu chng c nng ca bnh nhõn Error! Bookmark not defined Biu 3.4 Hỡnh thỏi u qua thm khỏm ni soi Error! Bookmark not defined Biu 3.5 V trớ xut phỏt u qua ni soi Error! Bookmark not defined Biu 3.6 T l cỏc loi tn thng biu mụ Error! Bookmark not defined 74 * Mụ bnh hc: 100% l u nhỳ o ngc vi loi tn thng biu mụ: t bo chuyn tip chim u th vi 85,3% v t bo vy l 14,7% ỏnh giỏ kt qu bc u PTNS UNMX cú s dng IGS: * iu tr phu thut u nhỳ mi xoang cú s dng IGS - Tỡnh hỡnh phu thut mi xoang: 23 bnh nhõn (67,6%) c m ln u, 11 bnh nhõn (32,4%) ó cú tin s PT mi xoang trc ú - PTNS loi v loi chim t l cao nghiờn cu u l 31,4%, PTNS loi v PTNS phi hp Caldwell-Luc gp ớt hn v cựng chim t l 17,6% - T l s dng nh v xỏc nh mc: sng s trc 85,3%, xng giy 82,4%, ng l t 64,7%, ngỏch trỏn 52,9% 100% bnh nhõn c dựng nh v ỏnh giỏ chu vi u * Bin chng v di chng ca phu thut: bin chng m 11,8% (4 bnh nhõn) u l chy mỏu, di chng sau m 8,7% Khụng gp bin chng nng nh dũ dch nóo tu, gim th lc, song th * Kt qu sau phu thut thỏng v tỏi phỏt - Khỏm ni soi sau thỏng: hc m tt 76,5%, trung bỡnh 14,7%, kộm 8,8% - T l tỏi phỏt u: 11,8% (4 bnh nhõn) thi gian theo dừi t 1-3 thỏng Tỏi phỏt sm ti v trớ xut phỏt ca u (75%) v gn v trớ xut phỏt (25%) u sút u 75 KIN NGH S dng IGS nờn c ch nh cho u nhỳ mi xoang nhng trng hp: + U nhỳ phi m li + Bnh tớch xoang sng, trỏn, bm; tip giỏp sn s, mt, thn kinh th hay ng mch cnh + Tn thng gõy bin dng, bt thng gii phu TI LIU THAM KHO Barnes L v cng s (2005) Pathology and Genetics Head and Neck Tumors, WHO Trn Vn Hp (2005) ii phu bnh hc, Nh xut bn Y hc H Ni Costa D.J v Sindwani R (2009) Advances in surgical navigation Otolaryngol Clin North Am 42(5), 799-811 Trn Vit Luõn (2013) Nghiờn cu phu thut ni soi ngỏch trỏn vi h thng hng dn hỡnh nh nh v ba chiu, Lun ỏn tin s y hc, Trng i hc Y Dc Thnh ph H Chớ Minh Metson R v Gray S.T (2005) Image-guided sinus surgery: practical considerations Otolaryngol Clin North Am., 38(3), 527-34 Kaza S, Capasso R v Casiano R.R (2003) Endoscopic resection of inverted papilloma: University of Miami experience Am J Rhinol, 17(4), 185-90 Melroy C.T v Senior B.A (2006) Benign sinonasal neoplasms: a focus on inverting papilloma Otolaryngol Clin North Am, 39(3), 601-617 Lawson W v Patel Z M (2009) The evolution of management for inverted papilloma: an analysis of 200 cases Otolaryngol Head Neck Surg, 140(3), 330-335 Chiu A.G v cng s (2012) Benign Neoplasms of the Sinonasal Tract Sinonasal Tumors, Jaypee Brothers Pvt Limited, 190-196 10 S Anari v S Carrie (2010) Sinonasal inverted papilloma: narrative review, J Laryngol Otol, 124(7), 705-715 11 Vrabec D P (1975), The inverted Schneiderian papilloma: a clinical and pathological study Laryngoscope, 85(1), 186-220 12 Lawson W, Ho B.T, Shaari C.M v cỏc cng s (1995) Inverted papilloma: a report of 112 cases Laryngoscope, 105(3 Pt 1), 282-288 13 Lombardi D, Tomenzoli D, Butta L v cng s (2011) Limitations and complications of endoscopic surgery for treatment for sinonasal inverted papilloma: a reassessment after 212 cases, Head Neck, 33(8), 1154-1161 14 Buchwald C.V v Larsen A.S (2005) Endoscopic surgery of inverted papillomas under image guidance-a prospective study of 42 consecutive cases at a Danish university clinic Otolaryngol Head Neck Surg, 132(4), 602-607 15 Eloy P (2013) Inverted papilloma of the maxillary sinus and endoscopic endonasal medial maxillectomy Romanian Journal of Rhinology, 3(9), 11-16 16 Myers E.N, Fernau J.L, Johnson J.T v cng s (1990) Management of inverted papilloma The Laryngoscope, 100(5), 481-490 17 Krouse J H (2000) Development of a staging system for inverted papilloma Laryngoscope, 110(6), 965-968 18 Lng Tun Thnh (2004) Tỡm hiu c im lõm sng, mụ bnh hc ca 30 tr ng hp u nhỳ mi xoang ti Vin Tai Mi Hng trung ng, Lun ỏn thc s, Trng i hc Y H Ni 19 Nguyn Bỏ Khoa (2006) Phu thut ni soi iu tr u nhỳ o ngc mi xoang, Lun ỏn chuyờn khoa II, i hc Y Dc Thnh ph H Chớ Minh 20 Nghiờm Th Thu H (2009) Bc u ỏnh giỏ kt qu iu tr u nhỳ mi xoang bng phu thut ni soi ti bnh vin Tai Mi Hng Trung ng, Lun ỏn chuyờn khoa II, Trng i hc Y H Ni 21 Nguyn Quang Trung (2012) Nghiờn cu c im lõm sng, cn lõm sng, ỏnh giỏ kt qu phu thut ni soi v yu t nguy c HPV u nhỳ mi xoang, Lun ỏn tin s y hc, Trng i hc Y H Ni 22 Hong Vn Nh (2014) Nghiờn cu c im lõm sng,mụ bnh hc, ct lp vi tớnh v ỏnh giỏ kt qu phu thut u nhỳ mi xoang ti bnh vin tai mi hng trung ng t 05/2012 -05/2014, Lun tt nghip Bỏc s ni trỳ, Trng i hc Y H Ni 23 Vừ Thanh Quang (2004) Nghiờn cu chn oỏn v iu tr viờm a xoang mn tớnh qua phu thut ni soi chc nng mi-xoang, Lun ỏn Tin s Y hc, Trng i hc Y H Ni 24 Jones N (2010) Applied surgical anatomy of the nasal cavity and paranasal sinuses Practical Rhinology, Taylor & Francis, 1-14 25 Dhingra P.L (2010) Anatomy of Nose Diseases of EAR, NOSE & THROAT, fifth edition, Elsevier India, 151 26 Nguyn Tn Phong (1998) Phu thut ni soi chc nng xoang, Nh xut bn Y hc, H Ni, -10 27 Levine H.L v Clemente M.P (2005) Surgical Anatomy of the Paranasal Sinus Sinus Surgery: Endoscopic and Microscopic Approaches, Thieme, 1-56 28 L Barnes (2002) Schneiderian papillomas and nonsalivary glandular neoplasms of the head and neck Mod Pathol, 15(3), 279-297 29 Lund V.J, Howard D.J v Wei W.I (2014) Epithelial Epidermoid Tumors Tumors of the Nose, Sinuses and Nasopharynx, Thieme, 77-92 30 Flint P.W v cng s (2014) Benign Tumors of the Sinonasal Tract, Cummings Otolaryngology: Head and Neck Surgery, sixth edition, Elsevier/Saunders, vol 1, 741-743 31 Sham C.L, Lee D.L, Van Hasselt C.A v cng s (2010) A case-control study of the risk factors associated with sinonasal inverted papilloma Am J Rhinol Allergy, 24(1), 37-40 32 Errico D.A, Zajacova J., Cacciatore A v cng s (2013) Occupational risk factors for sinonasal inverted papilloma: a case-control study Occup Environ Med, 70(10), 703-708 33 Phillips P.P, Gustafson R.O v Facer G.W (1990) The clinical behavior of inverting papilloma of the nose and paranasal sinuses: report of 112 cases and review of the literature Laryngoscope, 100(5), 463-469 34 Vừ Tn (1979) Tai Mi Hng thc hnh, 1, Nh xut bn y hc H Ni, 144 35 Elner V.M, Burnstine M.A, Goodman M.L v cng s (1995) Inverted papillomas that invade the orbit Arch Ophthalmol, 113(9), 1178-1183 36 Murphy J.T, Chandran A., Strachan D.R v cng s (2010) Bilateral inverted papilloma: A report of two cases and review of the current literature Indian J Otolaryngol Head Neck Surg, 62(3), 313-316 37 Wassef S.N, Batra P.S v Barnett S (2012) Skull Base Inverted Papilloma: A Comprehensive Review ISRN Surg, 2012, 1-34 38 Woodruff W.W v Vrabec D.P (1994) Inverted papilloma of the nasal vault and paranasal sinuses: spectrum of CT findings AJR Am J Roentgenol, 162(2), 419-423 39 Lee D.K, Chung S.K, Dhong H.J v cng s (2007) Focal hyperostosis on CT of sinonasal inverted papilloma as a predictor of tumor origin AJNR Am J Neuroradiol, 28(4), 618-621 40 Cardesa A v Slootweg P (2006) Pathology of the Head and Neck, Springer 41 Roh H.J, Procop G.W, Batra P S v cng s (2004) Inflammation and the pathogenesis of inverted papilloma Am J Rhinol, 18(2), 65-74 42 Thompson L.D.R v Wenig B.M (2011) Diagnostic Pathology: Head and neck, Amirsys 43 Woodworth B.A, Bhargave G.A., Palmer J.N v cng s (2007) Clinical outcomes of endoscopic and endoscopic-assisted resection of inverted papillomas: a 15-year experience Am J Rhinol, 21(5), 591-600 44 Busquets J.M v Hwang P.H (2006) Endoscopic resection of sinonasal inverted papilloma: a meta-analysis Otolaryngol Head Neck Surg, 134(3), 476-482 45 Budu V, Schnaider A v Bulescu I (2015) Endoscopic approach of sinonasal inverted papilloma - our 15 yearsexperience on 162 cases Romanian Journal of Rhinology, 5(17), 31-36 46 Shemen L.J v Shnayder Y (2006) Office-based intralesional cidofovir injections for nasal septal papilloma: a pilot study Otolaryngol Head Neck Surg, 135(1), 149-151 47 Karkos P.D, Fika Z, Benton J v cng s (2007) Conservative management of recurrent nasal squamous papilloma with topical immunomodulators Clin Otolaryngol, 32(3), 222-223 48 Nakano T, Cho H, Sugita M v cng s (1999) A case of a nasal cavity inverted papilloma treated with a local injection of -lnterferon Practica Oto-Rhino-Laryngologica, 92(11), 1201-1204 49 Kim Y.M, Kim H.S, Park J.Y v cng s (2008) External vs endoscopic approach for inverted papilloma of the sino-nasal cavities: a retrospective study of 136 cases Acta Otolaryngol, 128(8), 909-1014 50 Kennedy D.W v Hwang P.H (2012) Benign Sinonasal Tumors Rhinology: Diseases of the Nose, Sinuses, and Skull Base, Thieme, 394-408 51 Myers E.N v Carrau R.L (2008) Operative Otolaryngology: Head and Neck Surgery, Saunders/Elsevier 52 Lombard B (2006) Chirugie ORL assite par Ordinateur EMC techniquechirugical- Tờte et cou, Elsevier SAS 53 Citardi M.J v Batra P.S (2005) Image-guided sinus surgery: current concepts and technology Otolaryngol Clin North Am, 38(3), 439-452 54 Knott P.D, Batra P.S v Citardi M.J (2006) Computer aided surgery: concepts and applications in rhinology Otolaryngol Clin North Am, 39(3), 503-522 55 Metson R, Gliklich R.E v Cosenza M (1998) A comparison of image guidance systems for sinus surgery Laryngoscope, 108(8 Pt 1), 1164-1170 56 Metson R (2003) Image-guided sinus surgery: lessons learned from the first 1000 cases Otolaryngol Head Neck Surg, 128(1), 8-13 57 Reardon E.J (2005) The impact of image-guidance systems on sinus surgery Otolaryngol Clin North Am, 38(3), 515-525 58 Anon J.B (1998) Computer-aided endoscopic sinus surgery Laryngoscope, 108(7), 949-961 59 Aygun N, Uzuner O v Zinreich S.J (2005) Advances in imaging of the paranasal sinuses Otolaryngol Clin North Am, 38(3), 429-437 60 Kountakis S.E v cng s (2008) Revision Image-Guided Functional Endoscopic Sinus Surgery Revision Sinus Surgery, Springer, 251-267 61 Wormald P.J, Ooi E, van Hasselt C A v cỏc cng s (2003) Endoscopic removal of sinonasal inverted papilloma including endoscopic medial maxillectomy Laryngoscope, 113(5), 867-873 62 Palmer J.N v cng s (2013) Endoscopic medial maxillectomy for inverted papilloma Atlas of Endoscopic Sinus and Skull Base Surgery, Saunders/Elsevier, 199-208 63 Wormald P.J (2012) Endoscopic Resection of Tumors Involving the Maxillary Sinus, Pterygopalatine Fossa, and Infratemporal Fossa Endoscopic Sinus Surgery: Anatomy, Three-Dimensional Reconstruction, and Surgical Technique, Thieme, 200-205 64 Yoon J.H, Kim C.H v Choi E.C (2002) Treatment outcomes of primary and recurrent inverted papilloma: an analysis of 96 cases J Laryngol Otol, 116(9), 699-702 65 Benjamin Y.R, Maggie A.K, Elana O v cng s (2011) Pediatric Sinonasal Inverted Papilloma: An Uncommon Occurrence and Its Proposed Management Laryngoscope, 121, 108 66 Jurkiewicz D, Agnieszka S, Andrzej C (2008) Endoscopic sinus surgery in a 102-year-old woman with inverted papilloma Otolaryngol Head Neck Surg 138, 537-539 67 Gras-Cabrerizo J.R, Montserrat-Gili J.R, Massegur-Solench H v cng s (2010) Management of sinonasal inverted papillomas and comparison of classification staging systems Am J Rhinol Allergy, 24(1), 66-69 68 Minovi A, Kollert M, Draf W v cng s (2006) Inverted papilloma: feasibility of endonasal surgery and long-term results of 87 cases Rhinology, 44(3), 205-210 69 Bajaj M.S v Pushker N (2002) Inverted papilloma invading the orbit Orbit, 21(2), 155-159 70 Yousuf K v Wright E.D (2007) Site of attachment of inverted papilloma predicted by CT findings of osteitis Am J Rhinol, 21(1), 32-36 71 Chiu A.G, Jackman A.H, Antunes M.B v cng s (2006) Radiographic and histologic analysis of the bone underlying inverted papillomas Laryngoscope, 116(9), 1617-1620 72 Al Badaai Y, Chankowsky J, Mah M v cng s (2011) Radiological localization of Schneiderian papilloma Int Forum Allergy Rhinol, 1(6), 488-491 73 Karkos P.D, Khoo L.C, Leong S.C v cng s (2009) Computed tomography and/or magnetic resonance imaging for pre-operative planning for inverted nasal papilloma: review of evidence J Laryngol Otol, 123(7), 705-709 74 Mirza S, Bradley P.J, Acharya A v cng s (2007) Sinonasal inverted papillomas: recurrence, and synchronous and metachronous malignancy J Laryngol Otol, 121(9), 857-864 75 Lawson W, Le Benger J, Som P v cng s (1989) Inverted papilloma: an analysis of 87 cases Laryngoscope, 99(11), 1117-1124 76 Cheng T.Y, Ueng S.H, Chen Y.L v cng s (2006) Oncocytic schneiderian papilloma found in a recurrent chronic paranasal sinusitis Chang Gung Med J, 29(3), 336-341 77 Yoon B.N, Batra P.S, Citardi M.J v cng s (2009) Frontal sinus inverted papilloma: surgical strategy based on the site of attachment Am J Rhinol Allergy, 23(3), 337-341 78 Fakhri S, Citardi M.J, Wolfe S v cng s (2005) Challenges in the management of sphenoid inverted papilloma Am J Rhinol, 19(2), 207-213 79 Wright E.J, Chernichenko N, Ocal E v cng s (2011) Benign Inverted Papilloma with Intracranial Extension: Prognostic Factors and Outcomes Skull Base Rep, 1(2), 145-150 80 Tabaee A, Hsu A.K, Shrime M.G v cng s (2006) Quality of life and complications following image-guided endoscopic sinus surgery Otolaryngol Head Neck Surg, 135(1), 76-80 81 Reardon E.J (2002) Navigational risks associated with sinus surgery and the clinical effects of implementing a navigational system for sinus surgery Laryngoscope, 112(7 Pt Suppl 99), 1-19 82 Metson R (2003) Image-guided sinus surgery: lessons learned from the first 1000 cases Otolaryngol Head Neck Surg, 128(1), 8-13 83 Sadeghi N, Al-Dhahri S v Manoukian J.J (2003) Transnasal endoscopic medial maxillectomy for inverting papilloma Laryngoscope, 113(4), 749-753 84 Lawson W, Kaufman M.R v Biller H.F (2003) Treatment outcomes in the management of inverted papilloma: an analysis of 160 cases Laryngoscope, 113(9), 1548-1556 85 Kountakis S.E v cng s (2008) Revision sinus surgery for benign sinonasal tumors Revision Sinus Surgery, Springer, 159-165 86 Lee T.J, Huang S.F, Lee L.A v cng s (2004) Endoscopic surgery for recurrent inverted papilloma Laryngoscope, 114(1), 106-112 PH LC BNH N NGHIấN CU Khoa: S h s: Hnh chớnh: - H tờn bnh nhõn: - Tui: - Gii: nam n - a ch: - in thoi: - Ngh nghip: - Ngy vo vin: - Ngy vin: Lý vo vin: Triu chng c nng - Thi gian xut hin triu chng u tiờn cho n vo vin: thỏng - Ngt tc mi: cú [ ] khụng [ ] + Thi gian xut hin: + Ngt tng dn: cú [ ] khụng [ ] + Bờn phi [ ] bờn trỏi [ ] Hai bờn [ ] + Tng lỳc [ ] liờn tc [ ] - Chy mi nhy cú [ ] khụng [ ] + Xut hin t bao gi: + Bờn phi [ ] bờn trỏi [ ] Hai bờn [ ] + Tng lỳc [ ] liờn tc [ ] - Chy mỏu mi: cú [ ] khụng [ ] + Chy t nhiờn [ ] va chm [ ] + Xut hin t bao gi: + S lng: nhiu [ ] trung bỡnh [ ] ớt [ ] + S ln chy: + Khong cỏch gia cỏc ln chy mỏu mi: - Gim khu giỏc: cú [ ] khụng [ ] + Xut hin t bao gi + Tớnh cht: gim ngi [ ] mt ngi [ ] - au nhc vựng mt: cú [ ] khụng [ ] - Triu chng khỏc: cú [ ] khụng [ ] Tin s: - Tin s phu thut mi xoang trc ú: + Chn oỏn: + iu tr: + S ln phu thut: - Viờm mi d ng: cú [ ] khụng [ ] - Viờm mi xoang mn tớnh: cú [ ] khụng [ ] Triu chng thc th - Ton thõn: + Th trang: bộo [ ] trung bỡnh [ ] gy [ ] + Da xanh, niờm mc nht: cú [ ] khụng [ ] - Ni soi tai mi hng: + Hỡnh thỏi u: chựm nho [ ] qu dõu [ ] polyp [ ] Khỏc [ ] + Chõn bỏm u: Khụng xỏc nh [ ] Xỏc nh [ ] - Cỏc b phn khỏc: + Du hiu mt: + Du hiu thn kinh s nóo: + Du hin khỏc (nu cú): Kt qu gii phu bnh: Mụ bnh hc Trc m Sau m U nhỳ thng U nhỳ o ngc U nhỳ t bo ln a axit Ung th húa Tn thng khỏc - Tn thng biu mụ: Biu mụ chuyn tip [ ] Biu mụ vy [ ] Biu mụ tr [ ] Phim chp MSCT (CT scanner 64 dóy) - c im tn thng trờn phim MSCT c im tn thng tng sinh xng Chi xng X cng lan ta U dng thựy Mũn xng Gión rng l thụng xoang hm U cú cung Canxi u Cú V trớ: Khụng - i chiu v trớ tn thng trờn phim MSCT vi giai on Krouse Giai on Krouse Tn thng trờn MSCT V trớ tn thng trờn CLVT Cú - i chiu phu thut Khụng Cú Hc mi n thun PHLN Xoang sng trc Ngỏch trỏn Xoang hm Xoang sng sau Xoang bm Xoang trỏn Xõm ln mt Xõm ln ni s Xõm ln ngoi mi xoang - Giai on trờn MSCT: + Giai on I [ ] sau phu thut: + Giai on II [ ] sau phu thut: + Giai on III [ ] sau phu thut: + Giai on IV [ ] sau phu thut: - Cỏc bt thng v gii phu: Phu thut Cỏch thc phu thut: Loi [ ] Loi [ ] Loi [ ] Caldwell Luc+PTNS [ ] V trớ xut phỏt u m: V trớ c s dng pointer nh v m: + ng l t: cú [ ] khụng [ ] + Sng s trc: cú [ ] khụng [ ] + Sng s sau: cú [ ] khụng [ ] + Ngỏch trỏn: cú [ ] khụng [ ] + Xoang trỏn: cú [ ] khụng [ ] + Xng giy: cú [ ] khụng [ ] Khụng + + + + + nh mt: cú [ ] khụng [ ] Xoang bm: cú [ ] khụng [ ] Thn kinh th giỏc: cú [ ] khụng [ ] ng mch cnh trong: cú [ ] khụng [ ] Chu vi uL cú [ ] khụng [ ] Bin chng v di chng - Bin chng phu thut: + Chy mỏu: cú [ ] khụng [ ] + Tn thng mt: cú [ ] khụng [ ] + Dũ dch nóo ty: cú [ ] khụng [ ] + Tn thng ni s: cú [ ] khụng [ ] + Bin chng khỏc: cú [ ] khụng [ ] - Bin chng sau phu thut Bin chng sau phu thut v di Trong m chng Chy mỏu T mỏu mt Gim th lc Song th Dũ DNT So dớnh Thng vỏch ngn Viờm mng nóo Bin chng khỏc 10 Tỏi khỏm: - Hi bnh: + Ngt tc mi: cú [ ] khụng [ ] + Chy mi nhy m: cú [ ] khụng [ ] + Chy mỏu mi: cú [ ] khụng [ ] + Gim ngi, mt ngi: cú [ ] khụng [ ] + au nhc vựng mt: cú [ ] khụng [ ] Sau m - Thm khỏm ni soi: Tt Trung bỡnh Kộm thỏng thỏng - Tỏi phỏt: Tỏi phỏt thỏng Cú Khụng - V trớ tỏi phỏt: thỏng ... thuật nội soi u nhú mũi xoang có sử dụng IGS với hai mục ti u sau: Mô tả đặc điểm lâm sàng, MSCT mô bệnh học u nhú mũi xoang Đánh giá kết sau tháng ph u thuật nội soi u nhú mũi xoang có sử dụng. .. kết ph u thuật nội soi u nhú mũi xoang có sử dụng hệ thống hướng dẫn hình ảnh định vị (IGS/ IGNS) Vì tiến hành đề tài: Nghiên c u đặc điểm lâm sàng, cận lâm sàng đánh giá kết sau tháng ph u thuật. .. hợp lỗ ngách PT : Ph u thuật PTNS : Ph u thuật nội soi PTNSMX : Ph u thuật nội soi mũi xoang PTV : Ph u thuật viên UNĐN : U nhú đảo ngược UNMX : U nhú mũi xoang MỤC LỤC ĐẶT VẤN