口腔颌面部静脉畸形1412例临床报告

目的 :评价鱼肝油酸钠和平阳霉素单独或联合瘤体内注射治疗口腔颌面部静脉畸形的疗效和安全性。方法 :对 764例患者应用 5 %鱼肝油酸钠 ,2 98例患者应用平阳霉素 ,3 5 0例患者联合应用鱼肝油酸钠和平阳霉素进行瘤体内注射。通过随访和临床观察 ,分析其疗效和安全性。结果 :随访 1～ 14年 ,鱼肝油酸钠组有效率 89.3 % ,平阳霉素组 88.2 % ,联合用药组 95 .4%。鱼肝油酸钠组与平阳霉素组比较 ,有效率无显著性差异 (P >0 .0 5 ) ,联合用药组有效率明显高于鱼肝油酸钠组和平阳霉素组 (P <0 .0 5 )。鱼肝油酸钠组注射局部均有不同程度的肿胀 ,治疗有效的 5 97例中有 48例 ( 8% )复发 ;平阳霉素组有 9例 ( 3 % )出现发热反应。结论 :鱼肝油酸钠或平阳霉素瘤内注射治疗口腔颌面部静脉畸形均有良好的疗效 ,两者联合应用疗效更好、副作用小     

平阳霉素联合鱼肝油酸钠治疗颌面部静脉畸形的疗效观察

目的:探讨平阳霉素、地塞米松、鱼肝油酸钠联合应用进行口腔颌面部静脉畸形瘤体注射的临床疗效。方法 :92例颌面部静脉畸形患者随机分为A、B两组,各46例。A组注射平阳霉素、地塞米松、鱼肝油酸钠;B组仅注射平阳霉素、地塞米松。结果:92例患者均治愈。A组平均注射(3.20±0.13)次,疗程20 d。B组平均注射(4.90±0.15)次,疗程28 d。结论:平阳霉素、鱼肝油酸钠、地塞米松联用治疗口腔颌面部血管畸形,可缩短疗程,减少注射次数,安全、有效、易行。     

平阳霉素和泼尼松龙及鱼肝油酸钠联合注射治疗颌面部静脉畸形60例报道

目的：评价平阳霉素和泼尼松龙及鱼肝油酸钠联合注射治疗颌面部静脉畸形的疗效。方法：采用平阳霉素和泼尼松龙及鱼肝油酸钠联合病变内注射治疗60例颌面部静脉畸形患者。1周注射1次，3-5次为1个疗程，治疗结束后对疗效进行评价。结果：60例患者平均疗程3周，治疗完成后随访0．5～2a，治愈和显效率达94％，有效率为100％。结论：平阳霉素和泼尼松龙及鱼肝油酸钠联合注射治疗颌面部静脉畸形安全、廉价、高效、简便，疗程适中。     

硬化剂治疗口腔颌面部静脉畸形疗效的对比研究

目的:评价平阳霉素(PYM)单独使用或联合鱼肝油酸钠(SM)和地塞米松(DXM)瘤内注射治疗口腔颌面部静脉畸形的疗效和安全性。方法:选择100例口腔颌面部静脉畸形患者,随机分为两组。PYM组50例瘤腔内单独注射PYM;联合用药组50例,用DXM 5 mg/ml加2%利多卡因4ml瘤内注射,尔后再据年龄、瘤体大小,局部情况注射0.5～2.0mlSM。均5～7d注射1次,3～5次为一个疗程。分析其疗效和安全性。结果:治疗后经6～48个月随访。PYM组有效率84.0%,联合用药组有效率96.0%。明显高于PYM组(P<0.05)。PYM组有5例(10.0%)出现发热,联合用药组无发热病例(P<0.05)。结论:PYM、DXM、SM联合注射治疗口腔颌面部静脉畸形,具有疗程短、不良反应小等优点,是一种安全、可靠、简便的治疗方法,其疗效优于PYM单独瘤内注射治疗。     

平阳霉素与鱼肝油酸钠局部注射治疗颌面部静脉畸形的临床疗效比较

目的比较平阳霉素与鱼肝油酸钠分别注射治疗口腔颌面部静脉畸形的临床疗效。方法颌面部静脉畸形40例，20例小剂量平阳霉素局部注射治疗，20例5％鱼肝油酸钠局部瘤体注射治疗。结果平阳霉素有效19例（19／20），鱼肝油酸钠有效12例（12／20）。不良反应：平阳霉素10例（10／20），鱼肝油酸钠14例（14／20），前者主要为轻度全身反应，后者为局部严重反应。经x^2检验，差异有统计学意义（P〈0．05）。结论平阳霉素治疗颌面部静脉畸形疗效好，疗程短，是一种简便、有效的方法，平阳霉素疗效优于鱼肝油酸钠。     

三种药物联合注射治疗口腔颌面部静脉畸形350例疗效分析

目的总结分析平阳霉素(PYM)、地塞米松(DXM)和鱼肝油酸钠(SM)联合瘤内注射治疗口腔颌面部海绵状血管瘤(静脉畸形)的临床疗效。方法选取口腔颌面部静脉畸形350例,采用PYM、DXM、SM三药联合注射治疗。用DXM5mg/1ml,配PYM8mg,加1%普鲁卡因注射液4ml,按体表瘤体面积每1cm×1cm注射1ml混合液计算剂量,进行瘤体内注射,再按相对大剂量鱼肝油酸钠注射方法继续注射鱼肝油酸钠。每隔5～7d注射1次,3～5次为1个疗程。未愈者可重复联合治疗。结果治疗后经6～48个月随访,治愈246例(70.29%),基本治愈88例(25.14%),好转16例(4.57%),有效率为100%。结论PYM、DXM、SM联合注射治疗口腔颌面部静脉畸形,具有疗程短、不良反应小等优点,是一种安全、可靠、简便的治疗方法。     

鱼肝油酸钠、平阳霉素加地塞米松联合治疗颌面部静脉畸形的疗效评价

1材料与方法1.1临床资料本组共156例病例,其中男70例,女86例,年龄最小30d,最大56岁。1岁以内26例,1~10岁24例,11~20岁42例,21~30岁46例,30岁以上18例,患者多集中在11~30岁。156例中单发132例,多发24例,占14.1%。其中病变发生在眶及眶下区18例,颧颞区16例,唇区32例,颊区42例,腮腺咬肌区22例,舌、口底和颌下区16例,口咽区10例。病变大小为(0.5cm×0.5cm×0.5cm)~(5.0cm×6.0cm×10cm)。156例均表现为无痛性软质包块,表面皮肤或黏膜颜色正常或呈蓝紫色,可被压缩,体位移动试验阳性,穿刺有血,少数患者可扪及静脉石。1.2治疗方法所有患者治疗前行…     

面颈部巨大静脉畸形区室化硬化治疗的疗效观察

目的：评价区室化硬化治疗面颈部巨大静脉畸形的临床疗效。方法：对16例巨大面颈部静脉畸形患者（男12例，女4例，年龄6～22岁，平均14．9岁）的病损，用丝线缝扎间隔成多个小区室，再用OK-4320．1mg（儿童）或0．2mg（成人）和平阳霉素4mg（儿童）或8mg（成人）对每一区室进行多次经皮注射。每2周注射1次，连续注射3～5次。结果：全部病例术后均出现明显的局部肿胀和轻微疼痛，无严重并发症发生。1例出现暂时性面瘫，2周内自行恢复。经3～14个月（平均7．7个月）复查，4例病变完全消退，6例病变大部分消退，5例病变部分消退，1例病变少部分消退。全部患者肝肾功能正常，X线检查肺部无异常。结论：区室化OK-432和平阳霉素硬化治疗面颈部巨大静脉畸形是一种简单、安全和有效的治疗手段。     

平阳霉素治疗小儿面颈部静脉-微静脉畸形197例疗效观察

目的:总结平阳霉素(PYM)瘤内注射治疗小儿面颈部静脉-微静脉畸形(混合型血管瘤)的疗效。方法:选取1999-01~2005-01,用PYM注射治疗小儿面颈部静脉-微静脉畸形197例(244个瘤体),男性70例,女性127例,男女之比为1∶1.81,年龄1个月~12岁。7~10d注射1次,3~5次为一个疗程。结果:经6个月~6年随访,治愈率60.41%,基本治愈率35.53%,好转4.06%,总有效率为100%。按瘤体个数统计治愈和基本治愈率为96.31%。结论:PYM治疗静脉-微静脉畸形疗效高,疗程较短,是一种简便、安全的有效方法。     

平阳霉素与地塞米松联合注射治疗颌面部静脉畸形56例疗效观察

口腔颌面部血管性病变是一种常见病,约占全身同类病变的60%,其中又以静脉畸形为多。它导致的面部畸形和出血会严重影响患者身心健康和生活质量,我们近年来用平阳霉素(pinyangmycin,PYM)与地塞米松(Dexamethasonum,DXM)联合注射治疗颌面部静脉畸形56例,疗效满意,现总结分析如下。1病例与方法1.1一般资料本组56例,男性24例,女性32例;年龄最小为1岁,最大62岁。病变部位:面颊部16例(28.6%),颧颞部12例(21.4%),腮腺区9例(16.1%),舌部8例(14.3%),下颌下区8例(14.3%),唇部3例(5.3%)。病变最小1.0cm×1.2cm,最大6.0cm×7.0cm。1.2治疗方法治疗前…     

Head and neck chondrosarcoma: Analysis of 16 cases

Objective

Head and neck chondrosarcomas are rare, accounting for less than 12% of all chondrosarcomas. Few studies with larger series approach the clinicopathological characteristics of these tumours. The aim of this study was describe clinical findings, management and outcome of 16 cases of head and neck chondrosarcoma from a single institution.

Study design

The files of the Cancer Hospital A.C. Camargo were reviewed, and data from patients with head and neck chondrosarcoma were collected.

Results

Mean age was 36 years, with slight male predilection. The most common site affected was maxilla (43%). Surgery was the main modality treatment performed in 10 patients. Overall 5-year survival rate was 56.4%. Although it was not statistically significant, the most important factor affecting overall survival was tumour size.

Conclusion

Early diagnosis and adequate surgical resection are important to get better survival rates.     

头颈部软骨肉瘤16例临床分析

目的探讨头颈部软骨肉瘤的临床表现、病理特点、鉴别诊断、治疗及预后。方法回顾分析我院自1997～2009收治的16例头颈部软骨肉瘤的临床资料,并对其进行随访。结果头颈部软骨肉瘤好发于鼻腔鼻窦、颞骨、下颌骨、上颌骨,以鼻腔鼻窦最常见,临床主要表现为牙齿麻木、变色、鼻部症状、面瘫、听力改变、张口受限等。头颈部软骨肉瘤以原发性中央型软骨肉瘤为主,诊断主要靠病理,治疗以手术根治性切除为主,随访显示头颈部软骨肉瘤主要死亡原因为肿瘤侵入颅内。结论头颈部软骨肉瘤是一种以局部侵袭为主的恶性肿瘤,应强调首次行根治性手术,并辅以增敏放疗。     

两种硬化治疗方法对面颈部巨大静脉畸形的疗效比较

目的比较生物胶联合OK-432和平阳霉素与区室化联合OK-432和平阳霉素两种硬化治疗方法对面颈部巨大静脉畸形的临床疗效。方法选择63例面颈部巨大静脉畸形患者,随机分为A、B两组,A组30例,B组33例。A组以生物胶联合OK-432和平阳霉素经皮共同注射;B组对病灶行区室化后,经皮注射OK-432和平阳霉素。两组均经气管插管全麻下进行,相隔1个月注射1次,连续注射1～5次。比较2组的疗效和并发症。结果随诊6～12个月,平均8.2个月。A组平均治疗时间1.5个月,平均治疗次数2.5次,20例治愈,6例显效,2例有效,2例部分有效,没有无效病例;治愈率为66.67%,总有效率为100%。B组平均治疗时间3.5个月,平均治疗次数4.3次,13例治愈,9例显效,9例有效,2例部分有效,没有无效病例,治愈率为33.33%,总有效率为100%。A、B两组治愈率差异有统计学意义(χ2=21.01,P<0.01);A、B两组患者均有局部肿胀,无严重并发症出现,差异无统计学意义(χ2=1.56,P>0.05)。结论生物胶联合OK-432和平阳霉素经皮硬化术治疗面颈部巨大静脉畸形疗程短、疗效良好、安全、可靠。     

Cleidocranial dysplasia with bilateral polycystic ovarian disease and Mullerian abnormality of the uterus: a case report

We report an interesting case of cleidocranial dysplasia associated with an unusual finding of bilateral polycystic ovarian disease and bicornuate uterus with unicollis (Mullerian abnormality).     

The application of photodynamic therapy in the head and neck

Photodynamic therapy (PDT) is considered to be a minimally invasive treatment modality which shows great promise in premalignant and malignant conditions of the head and neck.This therapy can be applied before or after any of the conventional treatment modalities (ie surgery, radiotherapy or chemotherapy) and the treatment can be repeated as much as is needed at the same site. PDT uses photosensitizing drugs that are activated by exposure to light of a specific wavelength. Illumination of the suspected premalignant or malignant site by light at the activating wavelength results in cellular destruction by a non-free radical oxidative process. Most photosensitizers are administered systemically, although some can be applied topically in the treatment of skin cancer. Recent developments in photosensitizers and light delivery systems have substantially reduced treatment times and residual photosensitivity, while increasing the achievable depth of necrosis. Compared with standard approaches, PDT can achieve equivalent or greater efficacy in the treatment of premalignant and malignant lesions in the head and neck, with greatly reduced morbidity and disfigurement. The technique is simple, can commonly be carried out in outpatient clinics, and is highly acceptable to patients. It can be repeated to debulk large tumours progressively, and it can also be applied through interstitial light delivery to large solid tumours. Clinical Relevance: Photodynamic therapy is now shown to achieve equivalent or greater efficacy than standard treatment of premalignant and malignant lesions in the head and neck, with greatly reduced morbidity and disfigurement.     

Diagnosis and management of hemangiomas and vascular malformations of the head and neck

Oral Diseases (2010) 16 , 405–418 Vascular anomalies are congenital errors in vascular development. They frequently involve the head, neck, and oral cavity. Subdivided into vascular tumors (hemangiomas) and vascular malformations, vascular anomalies remain poorly understood. However, growing interest and recent advances in the diagnosis, management, and molecular characterization of these lesions are improving treatment strategies. The role of the multidisciplinary team cannot be overstated. This review provides both basic and up‐to‐date knowledge on the most common vascular anomalies encountered by physicians and practitioners. Because treatment options for vascular anomalies are widely variable and often debated, this report aims to provide a comprehensive approach to these lesions based upon current concepts and practical clinical experience.     

Intraosseous venous malformation of the craniofacial region: diagnosis and management

Vascular lesions mainly affect soft tissues, and less than 1% affect bone. In 1982, they were categorised by Mulliken and Glowacki as haemangiomas or vascular malformations, and an updated classification was subsequently published by the International Society for the Study of Vascular Anomalies. These lesions, however, continue to be termed haemangiomas and there is little attempt to differentiate between them. We report eight cases of intraosseous venous malformation that were inappropriately labelled as haemangioma by clinicians, pathologists, and radiologists. We highlight tailored management, and describe the clinical features, results of investigations to aid accurate designation (histological and immunohistochemical, including GLUT1 staining and cross-sectional imaging), and outcomes.