《耳鼻喉科学 Otolaryngology》课程教学课件（PPT讲稿）nose_7 neoplasms of nasal cavity and neoplasms of paranasal sinuses

Neoplasms of nasal cavity

Neoplasms of nasal cavity

Neoplasms ofnasal cavityBothbenign and malignanttumours of thenasal cavity are uncommon.Very oftentheir separation from tumours of paranasalsinusesis difficult except in early stagesIn additionto primarytumours,nasalcavity can be invadedby growths fromparanasalsinuses,neopharynx,cranialorbuccal cavity

Neoplasms of nasal cavity • Both benign and malignant tumours of the nasal cavity are uncommon. Very often their separation from tumours of paranasal sinuses is difficult except in early stages. In addition to primary tumours, nasal cavity can be invaded by growths from paranasal sinuses, neopharynx, cranial or buccal cavity

Neoplasms of nasal cavityBenignlesions areusuallysmoothlocalisedand coveredwithmucousmembrane.Malignant ones are usuallyfiable,have a granular surface and tend tobleedeasily

Neoplasms of nasal cavity • Benign lesions are usually smooth, localised and covered with mucous membrane. Malignant ones are usually fiable, have a granular surface and tend to bleed easily

Benignneoplasms1.Squamous papilloma.Verrucous lesionssimilarto skin warts can arisefrom thenasal vestibuleorlower part of nasalseptum.They may be single or multiplepedunculated or sessile.Treatmentis localexcisionwith cauterisation ofthe base topreventrecurrence.They can also betreatedbycryosurgeryorlaser

Benign neoplasms • 1. Squamous papilloma. Verrucous lesions similar to skin warts can arise from the nasal vestibule or lower part of nasal septum. They may be single or multiple, pedunculated or sessile. Treatment is local excision with cauterisation of the base to prevent recurrence. They can also be treated by cryosurgery or laser

Benignneoplasms2.Inverted papilloma (Transition cell papillomaorRingertz tumour).Itis so-namedbecausemicroscopically neoplastic epithelium is seem togrow towards underlying stroma rather than onthe surface.Mostly seen between 40-70 yearswith male preponderance (5:1).It arises from thelateral wall of nose andis always unilateral.Itpresents as red or grey masses which may betranslucent and oedematus, simulating simplenasal polypi

Benign neoplasms • 2. Inverted papilloma (Transition cell papilloma or Ringertz tumour). It is so –named because microscopically neoplastic epithelium is seem to grow towards underlying stroma rather than on the surface. Mostly seen between 40-70 years with male preponderance (5:1). It arises from the lateral wall of nose and is always unilateral. It presents as red or grey masses which may be translucent and oedematus, simulating simple nasal polypi

Benignneoplasmsinvertedpapilloma (Transition cellpapilloma orRingertztumour)Inverted papillomahas a markedtendencyto recur after surgical removal and mightbe associatedwith squamous cellcarcinomain 10-15%ofpatientsTreatmentis wide surgical excision bylateralrhinotomyormedial maxillectomyand enblocethmiodiectomy

Benign neoplasms • inverted papilloma (Transition cell papilloma or Ringertz tumour). Inverted papilloma has a marked tendency to recur after surgical removal and might be associated with squamous cell carcinoma in 10-15% of patients. Treatment is wide surgical excision by lateral rhinotomy or medial maxillectomy and en bloc ethmiodiectomy

Benignneoplasms3.PlemorphicadenomaRare tumour,usually arises from the nasalseptum.Treatmentis wide surgicalexcision

Benign neoplasms • 3. Plemorphic adenoma. Rare tumour, usually arises from the nasal septum. Treatment is wide surgical excision

Benignneoplasms4.SchwannomaandmeningiomaThey are uncommontumours which arefound intranasally.Treatment is surgicalexcisionbylateralrhinotomy

Benign neoplasms • 4.Schwannoma and meningioma. They are uncommon tumours which are found intranasally. Treatment is surgical excision by lateral rhinotomy

Benignneoplasms5.HaemangiomaItmay be:(a).Capillary haemangioma.It is soft,dark redpedunculated or sessible tumours arising fromanterior part of nasal septum.Usually it issmooth but may become ulcerated andpresentwith recurrence epistaxis and nasal obstructionTreatment is local excision with a cuff ofsurroundsmucpoerichondrium

Benign neoplasms • 5. Haemangioma. It may be: (a). Capillary haemangioma. It is soft ,dark red, pedunculated or sessible tumours arising from anterior part of nasal septum. Usually it is smooth but may become ulcerated and present with recurrence epistaxis and nasal obstruction. Treatment is local excision with a cuff of surrounds mucpoerichondrium

Benignneoplasms.5.Haemangioma(b).CavernoushaemangiomaItarisesfromtheturbinates onthelaterawall of nose. It is treated by surgicalexcisionwith prelimiary cryotherapyExtensivelesionsmay requireradiotherapyand surgical excision

Benign neoplasms • 5. Haemangioma. (b). Cavernous haemangioma. It arises from the turbinates on the lateral wall of nose. It is treated by surgical excision with prelimiary cryotherapy. Extensive lesions may require radiotherapy and surgical excision