开放性鼻整形切口治疗儿童先天性鼻中线囊肿及瘘管4例及文献复习  

Four cases of open rhinoplasty approach for congenital nasal dermoid and sinus cysts in children and literature review

作　　者：王蓬鹏[1] 葛文彤[1] 唐力行[1] 杨小健[1] 张薇 肖潇[1] 韩阳[1] WANG Pengpeng;GE Wentong;TANG Lixing;YANG Xiaojian;ZHANG Wei;XIAO Xiao;HAN Yang(National Center for Children's Health/Department of Otorhinolaryngology&Head and Neck Surgery,Beijing Children's Hospital,Capital Medical University/Beijing Key Laboratory for Pediatric Diseases of Otorhinolaryngology&Head and Neck Surgery/Beijing Pediatric Research Institute,Beijing 100045,China)

机构地区：[1]国家儿童医学中心/首都医科大学附属北京儿童医院耳鼻咽喉头颈外科/儿童耳鼻咽喉头颈外科疾病北京市重点实验室/北京市儿科研究所,北京100045

出　　处：《山东大学耳鼻喉眼学报》2022年第1期64-69,共6页Journal of Otolaryngology and Ophthalmology of Shandong University

基　　金：北京市医院管理局儿科学科协同发展中心专项(XTZD20180103);首都临床诊疗技术研究及转化应用(Z20110000520084);国家呼吸系统疾病临床医学研究中心“呼吸专项”(HXZX-20210501)。

摘　　要：目的 探讨开放性鼻整形切口在治疗儿童先天性鼻中线囊肿及瘘管的手术适应证及预后。方法 回顾分析4例先天性鼻中线囊肿及瘘管的儿童[男3例,女1例,2~6岁(平均4岁)]的临床资料、影像学资料、治疗效果及预后情况,所有患儿均在接受全身麻醉下开放性鼻整形切口入路切除病灶,术后规律随访,随访参数包括病灶复发情况、切口瘢痕情况、鼻尖形态。结果 4例诊断为先天性鼻中线囊肿及瘘管中,瘘口位置均位于鼻梁中下段及鼻尖,感染灶或囊肿位于鼻根部或一侧内眦水平,瘘管走行路径>1 cm。全部患儿术前均行鼻窦CT及MRI检查,术后规律随访19~24个月,4例患者术中均未出现并发症、术后无复发、鼻部切口瘢痕恢复好、鼻尖形态均正常。结论 开放性鼻整形切口入路用于儿童先天性鼻中线囊肿及瘘管切除的适应证为瘘口位于鼻尖至鼻部中下段,未与颅内沟通者,瘘管走行路径>1 cm,可在充分暴露病变范围的同时兼顾美容外观,效果理想,短期随访未观察到鼻部发育异常。Objective To evaluate the outcomes and indications of open rhinoplasty to treat congenital nasal dermoid and sinus cysts in children. Methods We retrospectively analyzed the clinical data of 4 children with congenital nasal dermoid and sinus cysts(3 males and 1 female) aged from 2 to 6 years at the time of surgery(average age: 4 years). All patients underwent open rhinoplasty approach for treatment. Postoperative follow-up was performed regularly. Follow-up parameters included recurrent lesions, incision scars, and nasal tip shape. Results Four children received an open rhinoplasty treatment. The fistulas were located between the middle part of the nasal bridge and the tip of the nose. All patients underwent preoperative CT and MRI to confirm the diagnosis and plan surgery. Intraoperative procedure using an open rhinoplasty approach for infectious lesions was performed under general anesthesia. Regular follow-up was conducted at 19-24 months after the operation. There were no reports of postoperative complications or recurrence, and follow-up examinations showed that the nasal incision scar recovered well;the shape of the nasal tip was normal in all cases. Conclusion Open rhinoplasty successfully treated congenital nasal dermoid and sinus cysts located in the lower third of the nose bridge to the tip, and the fistula path was longer than 1 cm without intracranial components. It can fully expose the lesion range while providing a perfect cosmetic outcome. It is safe in the pediatric population, with no significant effect on subsequent nasal growth during short-term follow-ups.

关 键 词：鼻整形切口 儿童 鼻中线囊肿及瘘管 先天性 鼻疾病 

分 类 号：R765.7[医药卫生—耳鼻咽喉科]