上颌骨动脉瘤样骨囊肿的诊断与治疗 (附4例报告及文献复习)

目的：探讨上颌骨动脉瘤样骨囊肿的诊断与治疗。方法：4例上颌骨动脉瘤样骨囊肿患者，1例在局部麻醉下行上颌窦根治术，3例在全身麻醉下行鼻侧切开术。结果：术后随访13个月～2年均无复发。结论：动脉瘤样骨囊肿以根治性手术切除为主，力求彻底。术前DSA检查确认瘤体供血动脉并栓塞，对减少术中出血和缩短手术及全身麻醉时间有显著作用。     

上颌窦动脉瘤样骨囊肿(附3例报告)

目的探讨上颌窦动脉瘤样骨囊肿的临床特征与治疗方法.方法回顾分析3例上颌窦动脉瘤样骨囊肿的相关文献,总结其临床表现、影像学特点及治疗效果.结果上颌窦动脉瘤样骨囊肿常见的症状为瘤体呈膨胀性生长、局部肿痛及临近器官压迫症状,较为特异的是穿刺有高压不凝血液喷出,影像学检查有助于诊断,3例患者均行手术切除,随访3～5年无复发.结论上颌窦动脉瘤样骨囊肿的X线征象表现为"气球样、皂泡样"改变,治疗应首选手术.     

上颌窦动脉瘤样骨囊肿

本文在国内首次报告1例上颌窦动脉瘤样骨囊肿。结合文献复习,认为本病的临床特点主要是患侧面颊部肿胀、鼻塞进行性加重和由此引起的继发症状;B超和CT检查有助于诊断;治疗多以手术切除为主。并就其发病机理和鉴别诊断进行讨论。     

上颌窦动脉瘤样骨囊肿1例

动脉瘤样骨囊肿(aneurismal bone cyst，ABC)是一种少见的骨瘤样病变，病因不明。主要发生于脊椎骨和长管状骨，罕见于扁骨及颅面骨。1997年6月我科遇到1例原发于右上颌窦的动脉瘤样骨囊肿．现报告如下。     

鼻内镜下切除鼻腔鼻窦内翻性乳头状瘤36例报告

目的探讨鼻内镜下切除鼻腔鼻窦内翻性乳头状瘤的可行性。方法回顾分析36例鼻腔鼻窦内翻性乳头状瘤经鼻内镜下切除,包括术前病情评估,术后随访。结果随访2~7年,2例复发,无恶变病例。结论术前鼻内镜、CT、MRI检查,可以确定病变范围,根据病变范围决定手术方式,经鼻内镜可以彻底切除Ⅰ、Ⅱ、Ⅲ期病变;Ⅳ期病变仍需行传统鼻侧切开。     

鼻内镜下鼻腔鼻窦低度恶性肿瘤切除术

目的 探讨鼻内镜下鼻腔鼻窦低度恶性肿瘤切除术的可行性及疗效.方法 回顾性总结鼻内镜下鼻腔鼻窦恶性肿瘤切除术病例12例,其中筛窦高分化鳞状细胞癌3例、嗅神经母细胞瘤3例、鼻中隔乳头状腺癌1例、鼻中隔黏液表皮样癌1例、腺样囊性癌4例.结果 根据内镜下所见及术后影像学检查证实12例肿瘤全部切除.所有病例随访1 5～52个月(...     

鼻内镜下三种方法切除儿童腺样体

目的总结鼻内镜下三种不同的手术方法治疗儿童腺样体肥大的经验,探索最佳的治疗方案。方法选择2009年6月～2011年10月全麻下经鼻内镜腺样体切除患儿1148例,应用90°成人鼻内镜经口腔径路低温等离子切除腺样体368例,90°成人鼻内镜经口腔径路Medtronic动力系统切吸术切除腺样体肥大677例,0°小儿鼻内镜下经鼻腔径路Medtronic动力系统切除腺样体103例。结果9 0°成人鼻内镜下口腔径路低温等离子切除腺样体的3 6 8例患儿术后无明显疼痛和出血,基本不影响进食;90°成人鼻内镜经口腔径路Medtronic动力系统切吸术切除腺样体的677例患儿中有较明显的疼痛,术后出血7例,占1.03%;0°小儿鼻内镜经鼻腔Medtronic动力系统切除腺样体手术时间长,操作困难,术后需要鼻腔填塞。结论 90°成人鼻内镜经口腔径路Medtronic动力系统切吸术和等离子消融术治疗腺样体肥大是很好的微创手术方法,但笔者更倾向于应用等离子消融术。     

鼻腔鼻窦内翻性乳头状瘤内镜下切除疗效分析

目的探讨单纯使用鼻内镜手术治疗鼻腔鼻窦内翻性乳头状瘤的疗效。方法回顾性分析32例接受鼻内镜手术的鼻腔鼻窦内翻性乳头状瘤患者的临床资料。结果32例患者均在鼻内镜下独立完成切除手术,无严重并发症发生。术后随访9～96个月,9例（28．1％）复发,其中6例在门诊局麻下,3例全麻下行鼻内镜手术完全切除复发病灶。结论鼻内镜下切除鼻腔鼻窦内翻性乳头状瘤有其独特的优势,对于Krouse分期T1～T3期病变,可首选鼻内镜手术。     

应用鼻内镜或鼻内镜辅助下鼻腔鼻窦低度恶性肿瘤手术探讨

目的 探讨应用鼻内镜或鼻内镜辅助下切除鼻腔鼻窦低度恶性肿瘤的治疗效果.方法 回顾分析28例鼻腔鼻窦低度恶性肿瘤临床资料,其中内翻性乳头状瘤恶变 16例,低度恶性骨肉瘤 1例,腺样囊性癌5例,低度间叶组织肿瘤2例,血管外皮瘤 3例,鼻腔混合瘤恶变1例.均在鼻内镜下或鼻内镜辅助下切除肿瘤.术后19例加放射治疗.结果 术后随访4年以上的24例无局部复发;1例低度间叶组织肿瘤,3例内翻性乳头状瘤恶变,1～2年后出现鼻腔复发,再次行同类手术,术后1例内翻性乳头状瘤恶变出现广泛脑膜侵犯死亡.结论 只要掌握好适应证,内镜或内镜辅助下可以切除部分鼻腔鼻窦恶性肿瘤,且创伤小,避免了颜面部瘢痕,提高了患者的生存质量.     

鼻内镜下颅底恶性肿瘤切除的初步探讨

目的探讨鼻内镜下切除侵犯颅底或原发于颅底的鼻腔鼻窦恶性肿瘤的可行性。方法回顾性分析1998年1月～2007年5月我院收治的40例鼻腔鼻窦恶性肿瘤侵犯颅底或原发于颅底恶性肿瘤患者,鼻内镜或鼻内镜辅助下手术切除病灶。结果4例患者术后6个月至2年内症状复发,再次鼻内镜手术效果满意。所有病例随访1年以上,死亡3例,失访7例,其中随访3年以上9例。结论鼻内镜下手术切除鼻腔鼻窦侵犯颅底或颅底原发性恶性肿瘤切实可行,但必须严格选择适应证。     

Aneurysmal bone cyst of paranasal sinuses

Aneurysmal hone cyst is rare in paranasal sinuses. It may be uni or multilocutar It occurs alone or with other benign bone lesions. The exact pathogenesis of it is still unknown. The aggressiveness of the disease needs early diagnosis and proper management to prevent recurrence. This report describes a case of aneurysmal bone cyst involving the ethmoid and maxillary sinuses which was successfully managed.     

Aneurysmal bone cyst of maxilla with ectopic molar tooth – A case report

Aneurysmal cysts of bone are rare non-neoplastic, locally aggressive lesion of bone with propensity for rapid growth, affecting mainly the long bones and spine. It rarely occurs in the head and neck region and within the head and neck mandible (especially the molar areas) is common. Aneurysmal cyst of bone involving the maxilla in the first decade of life is even rarer. We report a case of giant aneurysmal bone cyst of maxilla in eight-year-old male with ectopic molar tooth within the cyst. Is endoscopic excision possible? Endoscopic excision of the cyst was done successfully and no recurrence was noted even after 1 year of follow up.     

Aneurysmal bone cysts of the head and neck in pediatric patients: a case series

OBJECTIVES: To characterize aneurysmal bone cysts (ABCs) of the head and neck as seen at a tertiary care center. DESIGN: A case series. METHODS: A retrospective chart review of pediatric patients with aneurysmal bone cyst of the head and neck treated at the Hospital for Sick Children during the years 1994-2006 was carried out. RESULTS: Nine patients with ABC were treated. The average age at diagnosis was 9.3 years (range: 5 months-15 years), six males and three females. Four cysts originated in the paranasal sinuses, two in the mandible, one in the zygoma, one in the mastoid and one in the parietal bone. Two cases were associated with a previous localized trauma (mandible, zygoma). 5/9 presented with pain, 4/9 presented as an asymptomatic mass, 2/9 were associated with proptosis and nasal obstruction, 2/9 with nasal obstruction and 1/9 presented with an aural polyp. Seven cysts were successfully excised while one (in the pterygomaxillary fossa) is being followed conservatively. In one case the ABC was found to be secondary to an extensive osteoblastoma and this child continuous to be problematic. Follow-up time ranged from 2 years and 6 months to 10 years. CONCLUSIONS: ABC of the head and neck may vary in presentation and severity. Surgical removal is the treatment of choice at our institution and may provide a satisfying outcome. ABC may be secondary to an underlying bone pathology (e.g., osteoblastoma) which may make it refractory to treatment.     

Aneurysmal bone cyst in the sphenoid bone: treatment with minimally invasive surgery

Aneurysmal bone cysts are vascular lesions that destroy and expand bone. We report a recently treated case of an aneurysmal cyst of the sphenoid bone. A 14-year-old girl presented with frontal headaches, bouts of nausea, and vomiting. Computed tomography and magnetic resonance imaging showed typical features of an aneurysmal bone cyst. Arterial embolization was undertaken before surgery. The endoscopic transnasal procedure used allowed the complete removal of the aneurysmal bone cyst. This use of minimally invasive surgery makes this case of interest to surgeons of the skull base and sinuses.     

Primary aneurysmal bone cyst of the maxillary sinus in a child: case report and review of the literature

Our case report describes a primary aneurysmal bone cyst (ABC) of the maxillary sinus in a 12-year-old girl. The young patient presented with progressive diplopia, strabismus, and rapidly growing painless swelling of the left cheek. Imaging studies showed a heterogeneous contrast enhancing mass expanding the left maxillary sinus. The lesion was completely resected endoscopically and histological examination reported it as an ABC. The patient recovered well and is free of recurrence 9 months following surgery. ABC is a benign lesion usually associated with other bone pathology (fibrous dysplasia). It may behave aggressively and invade the orbit; so resection is necessary. Minimally invasive techniques such as endoscopic sinus surgery can be performed successfully in select cases. Long follow up is important because recurrence may occur, in which case further resection is warranted.     

鼻内开窗术治疗巨大上颌骨囊肿的临床察

目的探讨鼻内开窗术治疗巨大上颌骨囊肿的临床疗效。方法选择术前穿刺并且经鼻窦CT及MRI检查诊断为上颌骨囊肿的患者5例,囊肿均大于3.5 cm,所有患者采用鼻内镜下鼻内开窗术,根据囊肿与鼻腔、鼻窦的毗邻关系,分别选择鼻底开窗术、下鼻道开窗术,必要时行泪前隐窝开窗术,手术切除囊壁,其中2例患者因囊肿局限、主要靠近鼻底而选择单纯鼻底开窗术;2例患者因囊肿波及上颌窦内而选择下鼻道开窗术,其中1例术前因牙痛就诊,术后建议拔除患牙;1例患者因囊肿位置特殊,靠近上颌窦前壁因而行下鼻道开窗术联合泪前隐窝开窗术,对位缝合切口,术后予以碘仿纱条压迫及盐水冲洗,清理术腔,保证开窗口通畅引流。结果5例患者均未出现严重并发症,术后3个月左右囊腔上皮化,术后随访半年,窗口引流通畅,未见复发。结论鼻内开窗术是一种简单并且常用的手术方式,具有出血少、创伤小、复发率低等优点,保证开窗口通畅引流是减少上颌骨囊肿复发的关键。     

Submandibular approach to anterior C2-C4 disc space in the management of an aneurysmal bone cyst

We report a case of a ten-year-old girl with a large posterior neck mass, an aneurysmal bone cyst involving the upper cervical spine.Patient underwent tumor resection through a posterior approach and required subsequent anterior fusion and instrumentation of C2-C4 for stability. We describe a challenging transcervical submandibular approach that allowed anterior cervical discectomy with placement of interdisc spacer using pre-contoured allograft and plating to achieve anterior fusion. We demonstrated that this approach is safe and effective in children, and provides excellent visualization for direct access with a surprisingly large operative field for instrumentation.     

Aneurysmal bone cyst of the zygoma. A case report and review of the literature

Aneurysmal bone cyst is a cystic vascular osseous tumor. It is rare in the craniofacial area; it is even rarer in the zygoma. A case of aneurysmal bone cyst of the zygoma was presented. Its pathogenesis, clinical and radiological features and treatment options were discussed under the view of the literature.     

The 'hybrid' fibro-osseous lesion

A hitherto unreported 'hybrid' fibro-osseous lesion involving the nasal cavity and sinuses is reported. This lesion histologically demonstrated features of ossifying fibroma, cementifying fibroma and aneurysmal cyst. Whilst appearing benign in nature it behaved in a neoplastic manner which necessitated complete surgical excision. A combined clinical, radiological and histopathological approach is advocated and discussed in relation to the treatment of these lesions.