原发性鼻窦骨瘤临床分析  

Clinical analysis of primary nasal sinus osteoma

作　　者：董佳迪 陆美萍[1] 周涵[1] 张伟强[1] 李盈盈[1] 董伟达[1] 

机构地区：[1]南京医科大学第一附属医院耳鼻咽喉科

出　　处：《中华耳鼻咽喉头颈外科杂志》2015年第1期8-13,共6页Chinese Journal of Otorhinolaryngology Head and Neck Surgery

基　　金：江苏省“科教兴卫工程”医学重点学科研究基金(XK200719);江苏高校优势学科建设工程资助项目(PAPD2010-2013)

摘　　要：目的 总结并分析原发性鼻窦骨瘤的临床特征、诊断方法、手术入路及预后.方法 回顾性分析南京医科大学第一附属医院2007年1月至2013年12月收治的48例原发性鼻窦骨瘤患者的临床资料.所有患者均行术前CT检查,8例另行MRI检查,并依据影像检查结果制定手术方案.手术入路方式为鼻侧切开术14例,鼻内镜下鼻窦骨瘤切除术12例,冠状切口颅骨切开术13例,颅面联合径路（颅底前入路-额颞入路术）4例,传统Caldwell-Luc进路手术5例.结果 本组患者术后病理诊断密质型骨瘤20例,松质型骨瘤15例,混合型骨瘤13例.该组48例鼻窦骨瘤患者术后6例失访,余42例平均随访6个月至5年,有5例骨瘤复发.本组患者术后并发鼻窦黏液囊肿4例,脑脊液鼻漏3例.结论 鼻窦骨瘤较常见,CT和/或MRI有助于评估肿瘤的大小、位置、可能的来源和手术方案的制定.手术切除是主要治疗方式,鼻侧切开术和鼻内镜下鼻窦骨瘤切除术可切除绝大多数肿瘤.鼻窦骨瘤预后好,较少复发.Objective To summarize and analyze the clinical features,diagnosis,surgical approaches and treatment outcomes of patients with primary nasal sinus osteoma.Methods A retrospective review of 48 cases with primary nasal sinus osteoma treated from January 2007 to December 2013 was performed.All patients underwent preoperative CT scan and postoperative histopathologic examination.The surgical approaches included lateral rhinotomy in 14 cases,nasal endoscopic resection in 12 cases,coronal surgical incision craniotomy in 13 cases,combined craniofacial approach in 4 cases,and Caldwell-Luc approach in 5 cases.Results The postoperative pathological diagnosis consisted of 3 variants,including 20 for compact type and 15 for cancellous type,and 13 for mixed type.Six cases were lost to follow-up and 42 cases were followed up for 6-60 months,5 cases recurred.The post-operative complications included sinus mucous cyst in 4 cases,cerebrospinal fluid leak in 3 cases.Conclusions Nasal sinus osteoma are common.CT or MRI is helpful to evaluate the osteoma size,location and possible sources,and to make operation scheme.Surgery is the first choice for sinus osteoma.Lateral rhinotomy and nasal endoscopic resection can be applied to most sinus osteoma.The prognosis of sinus osteoma is good,with fewer recurrence.

关 键 词：鼻窦肿瘤 骨瘤 鼻外科手术 预后 

分 类 号：R739.62[医药卫生—肿瘤]