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

doi:10.6040/j.issn.1673-3770.0.2021.419

摘要/Abstract

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。

关键词: 鼻整形切口, 儿童, 鼻中线囊肿及瘘管, 先天性, 鼻疾病

Abstract: 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.

Key words: Open rhinoplasty, Children, Nasal dermoid and sinus cysts, Congenital disorders, Nose disease

中图分类号:

R765.7

王蓬鹏,葛文彤,唐力行,杨小健,张薇,肖潇,韩阳. 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[J]. 山东大学耳鼻喉眼学报, 2022, 36(1): 64-69.

WANG Pengpeng, GE Wentong, TANG Lixing, YANG Xiaojian, ZHANG Wei, XIAO Xiao, HAN Yang. Four cases of open rhinoplasty approach for congenital nasal dermoid and sinus cysts in children and literature review[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2022, 36(1): 64-69.

参考文献

[1] 倪鑫, 张天宇. 实用儿童耳鼻咽喉头颈科学[M]. 2版. 北京: 人民卫生出版社, 2021: 424-428.
[2] Herrington H, Adil E, Moritz E, et al. Update on current evaluation and management of pediatric nasal dermoid[J]. Laryngoscope, 2016, 126(9): 2151-2160. doi:10.1002/lary.25860.
[3] Bilkay U, Gundogan H, Ozek C, et al. Nasal dermoid sinus cysts and the role of open rhinoplasty[J]. Ann Plast Surg, 2001, 47(1): 8-14. doi:10.1097/00000637-200107000-00002.
[4] Hartley BE, Eze N, Trozzi M, et al. Nasal dermoids in children: a proposal for a new classification based on 103 cases at Great Ormond Street Hospital[J]. Int J Pediatr Otorhinolaryngol, 2015, 79(1): 18-22. doi:10.1016/j.ijporl.2014.10.020.
[5] Hidalgo J, Redett RJ, Soares BP, et al. Meet in the middle: a technique for resecting nasocranial dermoids-technical note and review of the literature[J]. Childs Nerv Syst, 2020, 36(3): 477-484. doi:10.1007/s00381-020-04499-5.
[6] 杨小健, 张杰, 唐力行, 等. 儿童先天性鼻中线囊肿及瘘管切除术[J]. 中华耳鼻咽喉头颈外科杂志, 2020,55(3):230-235. doi:10.3760/cma.j.issn.1673-0860.2020.03.008. YANG Xiaojian, ZHANG Jie, TANG Lixing, et al. Excision for congenital nasal dermoid and sinus cyst in children[J]. Chinese Journal of Otorhinolaryngology Head and Neck Surgery, 2020, 55(3): 230-235. doi:10.3760/cma.j.issn.1673-0860.2020.03.008.
[7] 倪鑫. 儿童头颈肿瘤: 疾病系统论述及综合管理指南[M]. 北京: 人民卫生出版社, 2019: 106-110.
[8] Adil E, Rahbar R. Paediatric nasal dermoid: evaluation and management[J]. Curr Opin Otolaryngol Head Neck Surg, 2021, 29(6): 487-491. doi:10.1097/MOO.0000000000000765.
[9] Dennis SC, den Herder C, Shandilya M, et al. Open rhinoplasty in children[J]. Facial Plast Surg, 2007, 23(4): 259-266. doi:10.1055/s-2007-995818.
[10] Belinfante LS. History of rhinoplasty[J]. Oral Maxillofac Surg Clin North Am, 2012, 24(1): 1-9. doi:10.1016/j.coms.2011.10.002.
[11] Goodman WS, Charbonneau PA. External approach to rhinoplasty[J]. Laryngoscope, 2015, 125(7): 1505-1511. doi:10.1002/lary.25280.
[12] Gupta A, Svider PF, Rayess H, et al. Pediatric rhinoplasty: a discussion of perioperative considerations and systematic review[J]. Int J Pediatr Otorhinolaryngol, 2017, 92: 11-16. doi:10.1016/j.ijporl.2016.10.027.
[13] Hage J. Surgical approach to the external and internal nose: with a supplementary report on two cases of nasal glioma[J]. Br J Plast Surg, 1960, 12: 327-339. doi:10.1016/s0007-1226(59)80048-5.
[14] Kamil R J, Roxbury C, Boss E. Pediatric Rhinoplasty: A national surgical quality improvement program analysis[J]. The Laryngoscope, 2019,129(2): 494-499. doi:10.1002/lary.27304.
[15] Johnson MD. Management of pediatric nasal surgery(rhinoplasty)[J]. Facial Plast Surg Clin North Am, 2017, 25(2): 211-221. doi:10.1016/j.fsc.2016.12.006.
[16] Kopacheva-Barsova G, Nikolovski N. Justification for rhinoseptoplasty in children-our 10 years overview[J]. Open Access Maced J Med Sci, 2016, 4(3): 397-403. doi:10.3889/oamjms.2016.080.
[17] Kim HC, Jang YJ. Columellar incision scars in Asian patients undergoing open rhinoplasty[J]. JAMA Facial Plast Surg, 2016, 18(3): 188-193. doi:10.1001/jamafacial.2015.2178.

相关文章 15

[1]	杨扬,王晓旭,张杰. 儿童中耳胆脂瘤诊治进展[J]. 山东大学耳鼻喉眼学报, 2022, 36(1): 1-6.
[2]	高信忠,林宗通,沈翎,刘平凡,林兴,许杨杨. 咽鼓管球囊扩张联合腺样体切除术治疗儿童分泌性中耳炎疗效分析[J]. 山东大学耳鼻喉眼学报, 2022, 36(1): 7-12.
[3]	马宁,陈敏,刘薇,杨扬,邵剑波,郝津生,刘冰,张晓,段晓岷,张祺丰,张杰. 儿童颞骨骨折临床特点和治疗策略[J]. 山东大学耳鼻喉眼学报, 2022, 36(1): 13-19.
[4]	胡春燕,党攀红,张睿,樊孟耘. 儿童单侧感音性听力损失的听力学及影像学特征149例分析[J]. 山东大学耳鼻喉眼学报, 2022, 36(1): 31-36.
[5]	党攀红,张睿,胡春燕,王洁,樊孟耘. 儿童乳突-颞下迷路外面神经减压术8例临床分析[J]. 山东大学耳鼻喉眼学报, 2022, 36(1): 37-42.
[6]	刘珊珊, 韩书婧, 王晓旭, 李艳红, 倪鑫, 张杰. 儿童细菌性脑膜炎后听力损害危险因素的系统评价与Meta分析[J]. 山东大学耳鼻喉眼学报, 2022, 36(1): 48-54.
[7]	焦雪梅,杨扬,李春凤,张晓琳. 鼓膜置管对分泌性中耳炎患儿咽鼓管功能的影响[J]. 山东大学耳鼻喉眼学报, 2022, 36(1): 60-63.
[8]	李孟辉,郅莉莉,戚凯文,王珊珊,高倩,步美玲,姜荷云,冯绛楠,王金荣. 皮下免疫治疗对单一尘螨和合并霉菌过敏儿童哮喘的临床研究[J]. 山东大学耳鼻喉眼学报, 2022, 36(1): 75-80.
[9]	赵海涛, 王亚芳, 赫莉, 陈文静, 邢民者, 郑文娟,阎玉彦,刘晓峰. 可视喉镜在先天性舌根囊肿患儿手术麻醉中的应用[J]. 山东大学耳鼻喉眼学报, 2022, 36(1): 106-110.
[10]	师晓丽, 牟鸿. 多学科联合诊治重度儿童阻塞性睡眠呼吸暂停综合征并发肺动脉高压1例[J]. 山东大学耳鼻喉眼学报, 2022, 36(1): 116-119.
[11]	赵兴贺,樊明月,窦训武,贾广彪. 儿童原发扁桃体弥漫大B细胞淋巴瘤1例并文献复习[J]. 山东大学耳鼻喉眼学报, 2022, 36(1): 120-124.
[12]	龙婷,刘雨薇,王生才,张杰,李艳珍,张雪溪,刘悄吟,刘志勇,孙念,倪鑫. 内镜CO₂激光烧灼术治疗273例儿童先天性梨状窝瘘的临床分析[J]. 山东大学耳鼻喉眼学报, 2022, 36(1): 125-130.
[13]	袁晨阳,刘燕综述房振胜审校. 儿童阻塞性睡眠呼吸暂停低通气综合征对肺功能的影响[J]. 山东大学耳鼻喉眼学报, 2022, 36(1): 143-148.
[14]	万怡宁,张德军,傅则名,郭芳,郭颖媛,管国芳. 磁共振弥散加权成像在先天性中耳胆脂瘤精准诊断与JOS分期中的应用探讨12例[J]. 山东大学耳鼻喉眼学报, 2021, 35(6): 65-69.
[15]	刘艺,于明坤,孙伟,邵震,胡媛媛,毕宏生. 角膜塑形术控制儿童近视有效性与安全性的Meta分析[J]. 山东大学耳鼻喉眼学报, 2021, 35(6): 92-100.

多维度评价

Viewed

Full text

Abstract

Cited

Shared

Discussed