先天性鼻中线囊肿30例临床分析  

Clinical analysis of 30 cases of congenital midline nasal cyst

作　　者：郑玉琴 叶斌 吕静荣[1] 马衍[1] 黄琦[1] 向明亮 ZHENG Yuqin;YE Bin;Lü Jingrong;MA Yan;HUANG Qi;XIANG Mingliang(Department of Otolaryngology&Head and Neck Surgery,Xinhua Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200092,China;Department of Otolaryngology&Head and Neck Surgery,Ruijin Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200025,China)

机构地区：[1]上海交通大学医学院附属新华医院耳鼻咽喉头颈外科,上海200092 [2]上海交通大学医学院附属瑞金医院耳鼻咽喉科,上海200025

出　　处：《中国眼耳鼻喉科杂志》2021年第4期244-249,共6页Chinese Journal of Ophthalmology and Otorhinolaryngology

基　　金：国家自然科学基金(81670926、91949119)。

摘　　要：目的探讨先天性鼻中线囊肿的临床特点,为临床诊疗提供参考。方法回顾分析2006年2月~2019年5月在上海交通大学医学院附属新华医院耳鼻咽喉头颈外科住院接受手术治疗的先天性鼻中线囊肿患者的临床资料,总结其临床表现、影像学检查和病理结果,分析临床类型、病变范围与病理之间的关系。统计采用独立样本t检验和Fisher精确检验法。结果 30例患者中男性19例、女性11例;中位年龄为17个月。有局部感染史者16例、无感染史者14例。单纯囊肿22例,囊肿伴瘘管8例。影像学分类:Ⅰ类11例、Ⅱ类12例、Ⅲ类7例。根据病变累及范围进行个体化手术治疗。病理:皮样囊肿18例、表皮囊肿12例。病理为皮样囊肿者其局部感染比例更高(P<0.05),表现为囊肿伴瘘管者更多见(P<0.05),影像学检查病变范围属Ⅲ类的可能性更高(P<0.05)。术后随访中位时间为5.5年,所有病例无复发,鼻背部均无明显局部凹陷。结论先天性鼻中线囊肿的临床表现及术前影像学结果与其病理有一定相关性,根据临床表现及影像学结果准确判断肿块范围,有助于手术方式的选择和病变组织的彻底切除。Objective To summarize the clinical characteristics of congenital midline nasal cyst and to provide reference for clinical diagnosis and treatment. Methods The clinical data of 30 patients with congenital nasal midline cysts admitted to the Department of Otolaryngology Head and Neck Surgery in Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, from February 2006 to May 2019, were analyzed retrospectively. The clinical manifestations, radiographic studies and pathological findings were summarized, and the relationship between clinical types, lesion range and postoperative pathology was analyzed. The statistical methods were independent t-test and Fisher’s exact test. Results Thirty cases in the present study included 11 female and 19 male, with a median age of 17 months. Infection history was got from 16 cases and no infection history was found in 14 cases. Twenty-two cases presented as cysts, and 8 cases presented as cysts with fistulas. CT imaging revealed that the lesions of 11 cases were confined to type Ⅰ, 12 cases were type Ⅱ, and 7 cases were type Ⅲ. All cases were treated by individualized surgical procedures, according to the scope of the lesion. There were 18(60%) dermoid cysts and 12(40%) epidermoid cysts in pathology. Dermoid cysts were more common in patients with infection history(P<0.05), and in cases of cysts with fistulas(P<0.05). Preoperative imaging showed that cases with type Ⅲ of lesion were more likely to be dermoid cysts in pathology. The median time of follow-up period was 5.5 years. By the end of the follow-up, there was no signs of recurrence and no obvious local depression in the nose. Conclusions There is a significant correlation between the clinical manifestations or preoperative imaging results and the postoperative pathology of the congenital midline nasal cyst. Clinical features and imaging results were helpful for making the proper choice of operation and complete resection.

关 键 词：鼻 皮样囊肿 表皮囊肿 诊断 

分 类 号：R765.9[医药卫生—耳鼻咽喉科]