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]	朱希倩,王佳,孙祖贤,冯建秀,张梦佳,赵颖,王宏,姜敏敏. 上海市杨浦区2022—2024年6~9岁学龄儿童屈光状态分析[J]. 山东大学耳鼻喉眼学报, 2026, 40(3): 102-109.
[2]	宋艳玲,司元元,崔彦. 微量玻璃体切除治疗激光笔致儿童全层黄斑裂孔1例并文献复习[J]. 山东大学耳鼻喉眼学报, 2025, 39(6): 144-147.
[3]	刘南仙,杨泽垠,韩琳,张爱英,赵宇亮,薛静,孙怡君,邵永良. 视频脑电图在儿童复发性眩晕诊断中的意义[J]. 山东大学耳鼻喉眼学报, 2025, 39(5): 20-25.
[4]	黄焕,华红利,邓玉琴,江承洋,王雨薇,杨星海. 儿童过敏性鼻炎、扁桃体腺样体肥大和鼻窦炎之间相关性及其对临床指导价值[J]. 山东大学耳鼻喉眼学报, 2025, 39(5): 34-41.
[5]	刘欣,杜安石,王艳,谭青青,李俊萍,郭玉楠,兰长骏. 上睑下垂患者提上睑肌肌力与术后眼睑闭合的相关性[J]. 山东大学耳鼻喉眼学报, 2025, 39(5): 70-75.
[6]	王华,张丰珍,龙婷,赵靖,李宏彬,王生才,王桂香. 后颅窝肿瘤术后儿童气管切开原因及预后转归分析[J]. 山东大学耳鼻喉眼学报, 2025, 39(4): 168-173.
[7]	乐冰艳,邹剑,雷蕾,文巧,钱应雪. 儿童扁桃体微生物群与免疫调节及疾病关联[J]. 山东大学耳鼻喉眼学报, 2025, 39(4): 193-200.
[8]	王尧,陈静怡,杨颖超,苏开明. 先天性纤维蛋白原缺乏症儿童的扁桃体腺样体切除病例分析1例及文献复习[J]. 山东大学耳鼻喉眼学报, 2025, 39(3): 77-80.
[9]	黄爱萍,王娟,王丽,耿江桥,王亚芳,温鑫. 儿童原发扁桃体Burkitt淋巴瘤累及上颌骨和肺1例并文献复习[J]. 山东大学耳鼻喉眼学报, 2025, 39(3): 148-152.
[10]	刘畅,杨景朴,高雨,王文佳. 长春地区儿童变应性鼻炎变应原检测结果分析[J]. 山东大学耳鼻喉眼学报, 2025, 39(2): 51-58.
[11]	付圣尧,陈敏,庞文会,李娜. 内镜辅助个体化手术入路治疗儿童鼻中线囊肿及瘘管[J]. 山东大学耳鼻喉眼学报, 2025, 39(2): 65-71.
[12]	陈丹萍,何子键,虞幼军,周晓娓. 儿童突发性聋10年住院病例的疗效及预后相关因素分析[J]. 山东大学耳鼻喉眼学报, 2025, 39(1): 16-22.
[13]	杨娜,柳荫,郭宝,纪尧峰,成晨,张琛,董丽娜. 高频超声在儿童鼻骨骨折闭合复位术的应用研究[J]. 山东大学耳鼻喉眼学报, 2025, 39(1): 41-45.
[14]	王登茂,温鑫,耿江桥,张光远,刘晓峰. 儿童咽鼓管毛息肉合并鼻咽部错构瘤1例并文献复习[J]. 山东大学耳鼻喉眼学报, 2025, 39(1): 105-109.
[15]	姚婷婷,张德伦,李兰. 婴儿下咽部胃黏膜异位症引发咽喉反流症状1例并文献回顾[J]. 山东大学耳鼻喉眼学报, 2024, 38(6): 126-130.

多维度评价

Viewed

Full text

Abstract

Cited

Shared

Discussed