鼻窦骨化性纤维瘤的临床特点及手术方法  

Retrospective analysis on the clinical characteristics and surgical methods of ossifying fibroma of the sinuses

作　　者：安新山 李宁[1] 曹文栋[1] 张志梅[1] 张玲染 任国英[1] 王德超[1] AN Xinshan;LI Ning;CAO Wendong;ZHANG Zhimei;ZHANG Lingran;REN Guoying;WANG Dechao(Department of Otolaryngology Head and Neck Surgery,the No.4 People's Hospital of Hengshui,Hengshui,Hebei,053000,China)

机构地区：[1]衡水市第四人民医院耳鼻咽喉头颈外科,河北衡水053000

出　　处：《中国耳鼻咽喉头颈外科》2021年第12期750-753,共4页Chinese Archives of Otolaryngology-Head and Neck Surgery

摘　　要：目的收集鼻窦骨化性纤维瘤患者的临床资料,并对其临床特点及手术方法进行回顾性分析。方法将衡水市第四人民医院2012年6月~2019年12月收治的经病理证实为鼻窦骨化性纤维瘤的21例患者作为研究对象,术前完善CT、MRI等相关检查,根据病变情况予以不同手术方案治疗,并分析患者病变的影像学特点及手术要点。结果 CT下可见肿瘤病变以髓腔为中心向周围膨胀性生长,窦腔发生变形但边界清楚,病变内部不均匀,有低密度囊变区及致密骨样间隔。13例行鼻内镜下肿瘤切除术,6例行改良鼻侧切开术,1例行冠状切口颅骨切开术,1例行上颌窦根治术。手术彻底切除肿瘤18例,部分切除3例,平均手术时间(4.8±0.42)h,术中平均出血量(190.00±28.06)ml;术后随访期间,出现复发者2例(9.52%)。1例术后眼部出现瘀青、肿胀,1例并发脑脊液漏,均予以积极对症治疗。结论CT扫描是鼻窦骨化性纤维瘤最常用且价值较高的术前检查手段,鼻内镜切除肿瘤是常用手术方法,早期发现、准确诊断,尽早选择合理手术方案彻底切除病灶,是改善患者预后的关键。OBJECTIVE To collect clinical data of patients with ossifying fibroma of the sinuses,and to retrospectively analyze their clinical features and surgical methods.METHODS According to the principle of retrospective analysis,21 patients who have been pathologically confirmed as ossifying fibroma of the sinuses and admitted to the hospital from June 2012 to December 2019 were taken as the research subjects.CT,MRI and other related examinations were performed before the operation,and different operations were performed according to the disease.The imaging characteristics of the patient’s lesions and the key points of surgery were analyzed.RESULTSCT shows that the tumor lesions grow expansively around the medullary cavity as the center,the sinus cavity is deformed but the boundary is clear,the interior of the lesion is uneven,showing a low-density cystic area and a dense bone-like interval.Thirteen cases underwent endoscopic tumor resection,6 cases underwent modified nasal incision,1 case underwent coronal incision craniotomy,and 1 case underwent radical maxillary sinus resection.The tumor was completely resected in 18 cases and partially resected in 3 cases.The average operation time was (4.8±0.42)hours,and the average intraoperative blood loss was (190.00±28.06)ml.During the postoperative follow-up,2 cases(9.52%) had recurrence.One case had bruises and swelling of the eyes after operation,and one case had cerebrospinal fluid leakage,all of which received active symptomatic treatment.CONCLUSIONCT scan is the most commonly used and valuable preoperative examination method for ossifying fibroma of the sinuses.Endoscopic resection of tumor is a common surgical method.Early detection and accurate diagnosis,early selection of a reasonable surgical plan and complete resection of the lesion are the key to improve the prognosis.

关 键 词：鼻窦 纤维瘤 骨化性 纤维发育不良 骨 肿瘤侵润 内窥镜检查 手术方式 

分 类 号：R739.62[医药卫生—肿瘤]