乳突部骨化纤维瘤诊治体会  

Diagnosis and treatment of ossifying fibroma of the mastoid process

作　　者：夏云琪 汤勇[1] 宰雄跃 李璟[1] 何璐 XIA Yunqi;TANG Yong;ZAI Xiongyue;LI Jing;HE Lu(Department of Otorhinolaryngology,First Affiliated Hospital of Kunming Medical University,Kunming 650032,China;Department of Sports Medicine,First Affiliated Hospital of Kunming Medical University,Kunming 650032,China)

机构地区：[1]昆明医科大学第一附属医院耳鼻咽喉科,云南昆明650032 [2]昆明医科大学第一附属医院运动医学科,云南昆明650032

出　　处：《中国耳鼻咽喉颅底外科杂志》2022年第5期80-83,共4页Chinese Journal of Otorhinolaryngology-skull Base Surgery

基　　金：人社部留学回国人员择优资助项目(2011WS0051)。

摘　　要：目的通过对罕见案例分析和文献复习,探讨乳突部骨化纤维瘤的临床表现、诊断及治疗,提高对该病的认识,减少临床漏诊误诊。方法分析2020年8月24日就诊的1例乳突部骨化纤维瘤的女性患者,完善术前临床及影像学检查后,在全麻下行乳突部肿瘤切除术,术后随访12个月。结果术后病理诊断为骨化性纤维瘤。患者术后恢复可,无呕吐、眩晕及面瘫。术后随访12个月,患者未再诉头痛及耳鸣等不适,无复发。结论发生在乳突部的骨化纤维瘤临床上十分罕见,早期无明显临床表现,易被漏诊。目前认为影像学与组织病理学分析是确诊及分类的主要依据,手术切除是患者出现临床症状后的首选的治疗方法,而具体的治疗方式应根据肿块的大小、侵袭程度、周围结构受累情况、临床表现以及患者的预后、耐受程度来灵活选择。Objective To discuss the clinical manifestations,diagnosis and treatment of ossifying fibroma(OF)of the mastoid process by reporting a rare case and reviewing the relevant literature,so as to improve the understanding of this disease and reduce missed diagnosis and misdiagnosis.Methods A female patient with ossifying fibroma of the mastoid was reported,who was admitted to hospital on August 24,2020.After clinical and imaging examinations were performed,and the mastoid tumor was removed under general anesthesia.Postoperative follow-up was 12 months.Results The postoperative pathological diagnosis was of ossifying fibroma.The patient recovered without vomiting,vertigo and facial paralysis.After 12 months of follow-up,the patient did not complain of headache,tinnitus and other discomfort,and no recurrence.Conclusion OF is rare to occur in the mastoid of temporal bone.There is no obvious clinical manifestations in the early stage of the disease,which is easy to be missed.This paper emphasizes that in ossifying fibroma:imaging and histopathological analysis is the main basis of diagnosis and classification.Surgical resection is a preferred selection when the patient develops clinical manifestations,and the specific treatment method of OF should be flexibly selected according to the mass size,limitations,degree of invasion,involvement of surrounding structures,clinical manifestations,prognosis and tolerance of patients.

关 键 词：耳部疾病 骨化纤维瘤 临床表现 诊断 治疗 

分 类 号：R764.1[医药卫生—耳鼻咽喉科]