基于CT的髁突骨软骨瘤分类  

A classification system for osteochondroma of the mandibular condyle based on computed tomographic images

作　　者：魏文斌[1] 陈敏洁[1] 杨驰[1] 黄栋[1] 邱亚汀[1] 周琴[1] 

机构地区：[1]上海交通大学医学院附属第九人民医院.口腔医学院口腔外科上海市口腔医学重点实验室,上海200011

出　　处：《中国口腔颌面外科杂志》2015年第4期324-328,共5页China Journal of Oral and Maxillofacial Surgery

基　　金：国家自然科学基金(81100824);上海市教育委员会科研创新项目(12YZ044);上海交通大学医工交叉项目(YG2013MS59)~~

摘　　要：目的 ：介绍一种基于CT表现的髁突骨软骨瘤分类方法及针对不同类型采用不同手术方式治疗的经验。方法 ：选择2002年1月—2014年7月治疗的79例髁突骨软骨瘤患者。依据CT分为Ⅰ型（外生型）和Ⅱ型（弥散型）,依据分类选择不同的开放性手术治疗,并在术后进行定期随访,平均随访时间为22.1个月（6~120个月）。结果：Ⅰ型（外生型）64例（81.0%）,Ⅱ型（弥散型）15例（19.0%）。Ⅰ型又可分为5种亚型,前/前内侧（56.2%）、后/后内侧（4.7%）、内侧（15.6%）、外侧（6.3%）、巨大型（17.2%）。对Ⅰ型患者的治疗以单纯瘤体切除术为主,Ⅱ型则需采用髁突次全切除及正颌手术治疗或全切除术及肋软骨瓣转移重建术。在随访期内未发现肿瘤复发、髁突吸收及新畸形形成,患者面形基本得到恢复。结论：基于CT影像学特点对髁突骨软骨瘤进行分类,对术者选择合适的治疗方案具有指导意义。PURPOSE： To introduce a classification system of condylar osteochondroma based on computed tomographic（CT） images and to introduce the treatment experiences based on the classification. METHODS： From January 2002 to July 2014, a total of 79 patients with condylar osteochondroma were treated in our department. They all accepted open operation and regular follow-up after operation. The average follow-up period was 22.1 months（range： 6 to 120 months）.The clinical and radiologic data were reviewed. RESULTS： There were two categories： type Ⅰ（protruding expansion） in64 patients（81.0%） and type Ⅱ（globular expansion） in 15 patients（19.0%）. Type Ⅰ condylar osteochondroma may present 5 sub-types： anterior/anteromedial（56.2%）, posterior/ posteromedial（4.7%）, medial（15.6%）, lateral（6.3%）, and gigantic（17.2%）. For patients with type Ⅰ, local resection was the first choice. Subtotal condylectomy or total condylectomy with/without costochondral graft reconstruction was performed on patients with type Ⅱ. During the follow-up period, tumor recurrence, condylar absorption, and new deformity were not detected. Patients recovered to normal facial contour. CONCLUSIONS： Preoperative classification based on CT scans will help surgeons to choose the most appropriatee surgical procedure to treat condylar osteochondroma.

关 键 词：骨软骨瘤 髁突 分类 

分 类 号：R738[医药卫生—肿瘤]