Osteoma of the ethmoidal sinus: a rare case of recurrence

Osteomas are slow growing bony tumours that may form in the sinuses of the skull. Presenting complaints include headaches, cerebral symptoms, or visual disturbances, depending on the site of the tumour. We describe an unusual case of an osteoma in the ethmoid sinus that recurred 5 years after its resection at another hospital. The patient presented with proptosis, epiphora, and headaches. We approached the lesion and removed it through a lateral nasal incision. Two years later the patient was free of symptoms.     

Giant Osteoma of Mandible Causing Dyspnea: A Rare Case Presentation and Review of the Literature

Osteomas are benign slow growing tumors of bone. Tumors are usually asymptomatic until they attain remarkable size and cause asymmetry or dysfunction. In view of few reported cases of giant osteoma of mandible, this article presents a case of giant osteoma of left mandible in a 53-year old male causing dyspnea due to compression of air way space.     

颌面部肉瘤临床疗效分析

目的:探讨颌面部肉瘤的临床病理特点及其治疗效果。方法:对44例颌面部肉瘤患者的临床、病理、随访资料进行整理分析。结果:好发年龄为19～49岁,平均36岁,男女比例1.2∶1,病理分型以骨肉瘤居多,多发生在下颌骨,总生存率59%左右。结论:颌面部肉瘤病理类型多样,恶性程度高,易复发,淋巴转移罕见,晚期可有肺及多脏器转移。首次治疗时根治性切除是关键,如果切缘不足,或者有远处转移时,则须考虑放、化疗。     

软腭骨瘤1例报告及文献复习

骨瘤是常见的由分化成熟的骨组织构成的良性肿瘤,多来源于邻近骨质,发生于骨膜内层骨母细胞,由成骨性纤维组织、成骨细胞及所产生的新生骨组成。发生于口腔软组织的骨瘤极为罕见,作者报道1例软腭骨瘤病例,结合有关文献对其组织来源、病理分型、鉴别诊断和治疗等进行了讨论。     

髁突骨瘤的外科治疗:附3例报告

通过对我院近年收治的3例髁突骨瘤进行回顾分析,探讨髁突骨瘤的手术方式。肿瘤和髁突切除后,同期用患侧增生伸长的冠突或自体肋软骨移植形成颞下颌关节。术后随访3个月～2年,疗效满意。该术式是治疗髁突骨瘤较为理想的方式。     

口腔颌面部恶性周围神经鞘膜瘤:3例报告及文献复习

恶性周围神经鞘膜瘤(MPNST)是头颈部极为罕见的一类恶性肿瘤,相关文献报告较少。本文报告了我院2015年以来收治的3例MPNST病例,详细介绍患者治疗及转归情况,并通过结合国内外文献报告探讨该类疾病的特点。该疾病手术后复发率高,而患者死亡的主要原因为远处转移。     

颌面部神经内分泌癌2例临床病理分析

目的：报告2例罕见的颌面部神经内分泌癌,以便提高临床诊断和治疗水平。方法：分析2例颌面部神经内分泌癌的临床表现、组织学形态、免疫表型及预后,并对该疾病的相关文献进行复习。结果：2例颌面部原发神经内分泌癌患者,1例在术后半年发生局部复发并行第2次手术,另1例患者术后接受放疗,随访2年未见复发。结论：颌面部神经内分泌癌是一种罕见的高度恶性肿瘤,早期即可发生转移,预后差。     

颌面部恶性淋巴瘤15例早期临床诊断

目的:探讨颌面部恶性淋巴瘤的早期临床诊断方法及注意点。方法:总结近年来我科收治的15例早期颌面部恶性淋巴瘤的诊断方法和经验。结果:对临床高度怀疑恶性淋巴瘤的患者,全面分析临床表现,结合CT、B超等各种全身辅助和特殊检查,最终通过针吸活检和病理明确诊断。结论:肿块针吸或切取活检辅以全身系统性检查是诊断颌面部早期恶性淋巴瘤的有效手段。     

口腔颌面部金属异物取出61例临床总结

目的:探讨口腔颌面部金属异物最佳手术取出途径。方法:将我科1999—2008年口腔颌面部金属异物61例诊治情况进行分析总结。结果:61例中的65个口腔颌面部金属异物都顺利取出,没有发生伤口感染,创口均愈合良好。结论:口腔颌面部异物应用平板探测器X线数字成影(DDR)线片,必要时可行三维CT重建准确定位,在明确诊断后,尽量沿着原创口选择手术途径,如明视下手术取出困难可在X线透视下取出。     

改良梭形切口在颌面部皮肤良性肿瘤切除中的应用

目的 设计一种改良梭形切口,用于切除颌面部皮肤良性肿瘤。方法 经尸体实验。方法 经尸体实验、计算,证实此改良切口具有多方面优点后,用于切除24例颌面部皮肤良性肿瘤。结果 按肿瘤半径为0.5cm、1.0cm、1.5cm计算,改良梭形切口节省切除皮肤面积分别为17．22％、15．42％、16．98％;缝合切口时无张力（或张力小）,切口对合线平整,隐于皱纹线中,无“猫耳”。经1－7a随访,切口瘢痕愈合良好。结论 此改良切口优于传统松形切口,可推广应用于切除颌面部皮肤良性肿瘤。     

Peripheral Osteoma of the Body of Mandible: A Case Report

Osteoma is a slow growing benign tumor consisting of well differentiated compact or cancellous bone that increases in size by continuous growth. It can be of a central, peripheral, or extraskeletal type. The peripheral type arises from the periosteum and is rarely seen in mandible. Although completely curable with adequate surgical treatment, osteomas precede the clinical radiographic evidence of colonic polyposis/Gardner’s syndrome. Therefore they may be sensitive markers for the disease. Recurrence of peripheral osteoma after surgical excision is extremely rare. However it is appropriate to provide both clinical and radiographic follow up after surgical excision of peripheral osteoma. This article describes the case of a 45 year old male who presented with painless swelling of the right body of mandible and resultant cosmetic facial disfigurement and functional impairment.     

199例颌面颈部淋巴结结核病临床资料的回顾性分析

目的:分析199例颌面颈淋巴结结核患者的临床资料.方法:回顾性分析2010～2019年在我院通过病理检查确诊的199例患者临床资料.结果:男性62例,女性137例;45例患者有明显的疼痛不适、144例患者无明显疼痛不适;3例患者有其他部位的结核病史;临床检查触及的肿大淋巴结大部分为大小不一的多发淋巴结;肿大淋巴结在颈部分布情况Ⅴ区>Ⅱ区>Ⅰ区>腮腺区>Ⅵ区>Ⅲ区>Ⅳ区;CT诊断为考虑为结核47例、恶性肿瘤17例、感染性疾病19例、48例为性质待定;胸部X光片结果肺部或者胸膜有结核表现的为31例;比较前5年及后5年的典型的病理学特征即干酪样坏死出现率,差异有统计学意义(P<0.05);T-SPOT检查的患者为45例,结果为阳性者36例.结论:颌面颈部淋巴结结核为最常见的肺以外的结核性疾病,新疆地区作为高发地区有明显的年轻化的趋势,很要必要加强该群体的预防工作;临床上颈部淋巴结结核无特定的临床表现,典型的病理学特征出现率明显下降,对病理诊断带来了一定的困难;诊断方面CT增强扫描、T-SPOT检查的参考价值明显高于其他检查.     

颌面颈部猫抓病18例临床总结

目的：对颌面颈部猫抓病的临床表现、诊断和治疗进行探讨,以提高猫抓病的诊疗水平,避免误诊误治。方法：对1986-01—2007-01间收治的18例颌面颈部猫抓病的临床资料进行回顾性分析。结果：发病年龄4—56岁,平均年龄20．2岁;发病部位：腮腺区4例（22．22％）,颌下区5例（27．78％）,颏下区3例（16．67％）,上颈部5例（27．78％）,面颊部1例（5．55％）;病变淋巴结均行手术切除并送病理检查,病理诊断为猫抓病。结论：猫抓病的诊断较困难,详细询问猫、狗抓伤病史和豢养史,病变淋巴结切除活检是诊治本病的关键,避免与宠物接触是预防该病的最好措施。     

颌面部44例非霍奇金淋巴瘤的临床分析

目的：探讨颌面部ML的诊断方法和治疗措施。方法：对44例患者的临床资料进行回顾性分析。结果：44例中男性的发病明显多于女性,发病率随年龄增长而递增。B-NHL的发病明显多于T-NHL,B-NHL中高恶性占58％,低恶性占42％,而T-NHL全部为高恶性。舌根部及咽淋巴环的病变以中高恶性为多。治疗方法采用以COP和CHOP化疗方案为主的,包括手术、放疗和免疫治疗的综合性治疗方法。近期缓解率依其分期的和化疗疗程多少而不同,CR占36．3％,PR占59．0％,其中以手术切除 化疗的效果最好。结论：对于颌面颈部的肿块和溃疡不能以炎症解释,抗结核无效,应及时活检,并注意切取标本的方法。以COP和CHOP化疗为主的综合性治疗是最有效的治疗方法。     

巨大髁突骨瘤1例报告及文献复习

骨瘤是常见的由分化成熟的骨组织构成的良性肿瘤,多来源于邻近骨质,发生于骨膜内层的骨母细胞,由成骨性纤维组织、成骨细胞及所产生的新生骨组成。发生于髁突的巨大骨瘤较为罕见,本文报道1例巨大髁突骨瘤病例,并结合相关文献,对其组织来源、病理分型、鉴别诊断和治疗等进行讨论。     

Contribution of Ultrasonography to the Diagnosis of Submucosal and Subcutaneous Nodular Lesions of the Oral and Maxillofacial Region: Analysis of Cases

Objective

The aim of this study was to evaluate the contribution of ultrasonography in the establishment of the diagnosis of nonspecific nodular lesions of the oral soft tissues. We determined the indication of use and reliability of ultrasonography in the field of dentistry, considering whether it was of value in the conclusive diagnosis of these pathologies.

Materials and Methods

We recruited 65 patients from the Oral Medicine Unit of São Lucas Hospital, who had submucosal and subcutaneous nodules, without established diagnosis. They were subjected to ultrasonography of the lesion, carried out with standardization of the protocol and equipment, utilizing a Doppler system. The ultrasonographic report was prepared by an experienced professional, noting the imaging characteristics as well as the possibility of diagnosis. Two calibrated examiners analyzed the data, comparing the ultrasonographic report with the final diagnosis. Accordingly, we used established scoring, where zero corresponded to no contribution to the final diagnosis, 1 helped in the management of the case, and 2 when imaging determined the diagnosis.

Results

A zero score was obtained for 12.3 % of the examinations performed, and 1 and 2 accounted for respectively 41.5 and 46.1 %, totaling a contribution of about 88 %. Ultrasonography was of value in the diagnosis of vascular lesions in 93.3 % and of neoplasms in 87.5 %. In the salivary gland diseases, it contributed to the final diagnosis in 75 %.

Conclusion

The results demonstrated that ultrasonography is an effective tool in the determination of the definitive diagnosis of nonspecific nodular lesions of the soft tissues of the oral and maxillofacial region.     

口腔颌面部异物36例临床分析

目的:探讨口腔颌面部异物伤的诊断与治疗及影像学诊断的重要性。方法 :选择2003-01—2010-12期间收治的,影像和病历资料完善的口腔颌面部异物存留伤36例。分析异物类型,并对临床疗效进行评估。结果:36例异物存留伤患者中,金属异物12例,非金属异物24例。择期异物取出26例;需要急诊清创者10例,而清创术可一期取出异物者6例,4例延期取出。30例经常规X线片检查后,需经CT或三维CT检查进一步定位,评估手术取出的可行性及风险。其中26例经手术取出,4例保留并观察。结论:三维CT在非金属异物存留伤诊疗中起到重要的作用;必须根据异物大小、部位及与周围大血管的毗邻关系,患者全身情况等综合因素判定是否手术及手术时机。     

Management and Treatment Outcomes of Maxillofacial Fibro-osseous Lesions: A Retrospective Study

Introduction

Fibro-osseous lesions are a diverse group of bone disorders and include developmental, reactive or dysplastic diseases and neoplasms. They share overlapping clinical, radiographic and histopathologic features and demonstrate a wide range of biological behaviour.

Aim

To evaluate the characteristics, treatment and outcome of benign fibro-osseous lesions of the jaws.

Patients and Method

All patients with fibro-osseous lesions of the jaws treated at the department of Oral and Maxillofacial Surgery of the Kamineni Institute of Dental Sciences from 2007 to 2013 were included in this study.

Results

Six males and four females were treated. Juvenile ossifying fibroma was most often encountered (40 %), and the mandible was the most frequent location (70 %). Main clinical feature in most of the cases was a painless expansile swelling with facial asymmetry, and radiologically mixed (radiolucent and radiopaque lesions) were seen in majority of cases. All cases were surgically treated and histopathologically confirmed. Segmental ostectomy was performed in six cases; maxillectomy was done in one case and excision along with margin in three cases. Mean follow-up was of 3.3 years with no recurrence.

Conclusions

Fibro-osseous lesions, although sharing similar microscopic features, exhibit a variety of clinical behavior rendering their treatment highly individualized. Radical treatment is the choice to achieve an outcome without recurrence.