山东大学耳鼻喉眼学报 ›› 2018, Vol. 32 ›› Issue (2): 73-78.doi: 10.6040/j.issn.1673-3770.0.2017.434

• ·论著· • 上一篇    下一篇

鼻窦骨纤维异常增殖症36例临床分析

刘晓静,王愿,张立庆,冯剑,赵青,宋圣花,周涵,董伟达   

  1. H201603);
    江苏省青年医学人才项目(QNRC2016614)第一作者:刘晓静。 E-mail:18360868661@163.com通讯作者:董伟达。 E-mail:weidadong2649@126.comDOI:10.6040/j.issn.1673-3770.0.2017.434鼻窦骨纤维异常增殖症36例临床分析刘晓静, 王愿, 张立庆, 冯剑, 赵青, 宋圣花, 周涵, 董伟达(南京医科大学第一附属医院〓江苏省人民医院耳鼻咽喉科, 江苏 南京 210029
  • 收稿日期:2017-10-19 出版日期:2018-03-20 发布日期:2018-03-20
  • 通讯作者: 董伟达. E-mail:weidadong2649@126.com
  • 基金资助:
    江苏省卫生计生委面上课题(H201603);江苏省青年医学人才项目(QNRC2016614)

Analysis of paranasal sinus fibrous dysplasia in 36 cases

LIU Xiaojing, WANG Yuan, ZHANG Liqing, FENG Jian, ZHAO Qing, SONG Shenghua, ZHOU Han, DONG Weida   

  1. Department of Otorhinolaryngology, The First Affiliated Hospital, Nanjing Medical University, Nanjing 210029, Jiangsu, China
  • Received:2017-10-19 Online:2018-03-20 Published:2018-03-20

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摘要： 目的 探讨鼻窦骨纤维异常增殖症的临床特征、手术方法及预后。 方法 回顾性分析南京医科大学第一附属医院2009年10月至2016年10月收治的36例鼻窦骨纤维异常增殖症患者的临床资料。所有患者均根据术前影像学结果制定手术方案:其中经鼻内镜鼻窦手术18例,传统Caldwell-Luc径路4例,鼻侧切开术7例,鼻内镜联合Caldwell-Luc径路4例,冠状切口颅骨切开术3例,冠状切口联合Caldwell-Luc径路2例。3例患者同时行鼻内镜下视神经管减压术。所有患者中28例行病变骨质彻底切除,8例行改善功能与外观的保守切除。 结果 36例平均随访6个月至5年,2例复发,余34例恢复良好。患者术后并发脑脊液鼻漏2例,颅内血肿1例。 结论 鼻窦骨纤维异常增殖症临床表现复杂,手术切除病变骨质是主要治疗方式,应在尽可能保留功能及外观的前提下,根据术前影像学检查及患者诉求个性化制定手术径路。该病症预后良好,较少复发及出现恶变。

关键词: 鼻窦肿瘤, 骨纤维异常, 外科手术, 预后

Abstract: Objective To explore the clinical features, surgical approaches, and treatment outcomes of patients with paranasal sinus fibrous dysplasia. Methods A retrospective review of 36 patients with paranasal sinus fibrous dysplasia treated between October 2009 and October 2016 was performed. All patients underwent surgery based on the results of preoperative imaging. Nasal endoscopic resection was performed in 18 cases, a Caldwell-Luc procedure in 4, lateral rhinotomy in 7, combined nasal endoscopic resection and Caldwell-Luc procedure in 4, coronal incision craniotomy in 3, coronal incision craniotomy combined with Caldwell-Luc procedure in 2, and optic canal decompression in 3. Results Of 36 cases followed for 6-60 months, 2 developed a recurrence and the remaining 34 recovered without difficulty. Cerebrospinal fluid rhinorrhea occurred in 2 cases, and 1 case had an intracranial hematoma. Of the 36 cases, 28 underwent radical bone resection and 8 underwent conservative excision to improve function and appearance. Conclusion Paranasal sinus fibrous dysplasia presents with complex clinical manifestations. Surgical resection of affected bone is the main treatment, while retaining function and appearance as much as possible, based on preoperative imaging and patient preferences. The prognosis is good, with low rates of recurrence or malignant transformation

Key words: Ranasal sinus neoplasm, Surgical procedures, operative, Rognosis, Fibrous dysplasia

中图分类号: 

  • R765.9
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