鼻腔呼吸道上皮腺瘤样错构瘤1例并文献复习

目的 探讨鼻腔呼吸上皮性腺瘤样错构瘤(REAH)的临床、影像、病理学特征及治疗。 方法 分析1例鼻腔REAH患者的临床资料并复习相关文献进行总结。 结果 鼻腔REAH临床表现常以鼻塞、嗅觉减退为主。影像学方面,嗅裂增宽>10 mm是本病在CT上的特征性表现。本病确诊主要依靠病理检查,其显微镜下特点是大量内衬呼吸道纤毛上皮的腺体显著增生。 结论 鼻腔REAH临床表现无特异性,因而影像学及组织学检查对本病的早期诊断尤其重要。内镜下切除肿瘤是本病的最佳治疗手段。     

Respiratory epithelial adenomatoid hamartoma of bilateral olfactory clefts associated with nasal polyposis: Three cases report and literature review

We report three cases of patients with respiratory epithelial adenomatoid hamartoma (REAH) of bilateral olfactory clefts associated with nasal polyposis. REAH is a kind of rare lesion which commonly occurs in nasal cavity, paranasal sinuses, and nasopharynx. Our cases were all localized in bilateral olfactory clefts which is very rare since the most common site reported in the past in nasal cavity is the posterior nasal septum and unilateral. Furthermore, our presented cases all associated with nasal polyposis which can provide greater evidence that inflammation can induce REAH development. Although REAH is benign lesion it can probably continue developing after operation if REAH was not completely resected. So during endoscopic sinus surgery (ESS), complete resection of the lesions is key point in successfully treatment of REAH. Although REAH arising from the rhinosinusal region is very rare rhinolaryngologists should know this entity thoroughly in order to differentiate it from inverted papilloma and adenocarcinoma since misinterpretation of this lesion may result in aggressive surgery for a benign lesion which could greatly affect patient's quality of life after operation.     

Respiratory epithelial adenomatoid hamartoma of the maxillary sinus

A case of respiratory epithelial adenomatoid hamartoma of the maxillary sinus is reported. Glandular hamartomas involving the sinonasal tract have received only limited documentation in the literature. The differential diagnosis of adenomatoid hamartoma includes schneiderian papilloma of the inverted type and adenocarcinoma. Limited but complete surgical resection is the treatment of choice.     

Cholesterol granuloma in the maxillary sinus

A 35-year-old male complained of recurring headache and nasal obstruction over a 4-year period. A Caldwell-Luc operation was subsequently performed on the left maxillary sinus and a greenish appearing material was removed. Microscopic examination of the tissue specimen showed a granulomatous tissue with typical cholesterol clefts and inflammatory changes consistent with chronic sinusitis. This entity is presented and reviewed.     

Respiratory epithelial adenomatoid hamartoma: a case report

Respiratory epithelial adenomatoid (READ) hamartoma is a recently described entity characterized by abnormal glandular formations arising from the epithelium of the nasal cavity. The etiology of the lesion is unclear and may be secondary to either sinonasal inflammation or developmental error. We present a case of a 54-year-old man with a unilateral nasal mass found to be consistent with READ hamartoma upon pathologic review. Although READ hamartomas are thought to be rare, awareness of the lesion is important since it may be confused with sinonasal adenocarcinoma, leading to overly aggressive treatment. Therefore, READ hamartoma should be included in the differential diagnosis of a unilateral nasal mass.     

鼻腔呼吸道上皮腺瘤样错构瘤

目的　分析19例鼻腔呼吸道上皮腺瘤样错构瘤（respiratory epithelial adenomatoid hamartoma,REAH）的临床特点。方法　回顾性分析我科经病理证实的19例鼻腔REAH,分析其临床、影像及病理学资料。结果　19例患者临床症状与慢性鼻窦炎及鼻息肉症状相似,其中8例有鼻内镜手术史。17例患者新生物位于双侧嗅区,2例位于鼻中隔。17例鼻窦CT示双侧鼻腔嗅区可见软组织呈膨胀性生长,鼻窦内可见不同程度的炎症表现,2例鼻窦CT示鼻中隔孤立肿物。结论　REAH的临床症状缺乏特异性,但该病并不少见,因其有独特的影像学及病理表现,所以临床医师应充分认识该病并术中取材准确,可以提高其诊断率及治愈率,降低术后复发。     

Spherulocytosis of the maxillary sinus: a case report

Spherulocytosis (myospherulosis) is an unusual foreign-body reaction usually occurring in tissues exposed to petrolatum-based products. Due to its occasional localization in the maxillary sinus, it is of interest to rhinologists and maxillofacial surgeons. The pathogenesis of spherulocytosis has remained a matter of controversy. We present the case of a 40-year-old female with no previous contact to petrolatum-based substances and suffering from spherulocytosis of the maxillary sinus. The review of literature with emphasis on etiopathogenesis and factors that predispose to the development of spherulocytosis, other than exposure to petrolatum-based ointment, are discussed.     

上颌窦胆固醇肉芽肿(附2例报告)

为探讨胆固醇肉芽肿形成的机理，报告２例发生于上颌窦的胆固醇肉芽肿。该病的常见症状是鼻阻塞，严重者可引起骨质破坏。其病因可能源于上颌窦窦口阻塞、粘膜息肉样病变内部出血或上颌窦囊肿瘤壁内胆固醇沉积。文献复习表明：窦腔通气不良，长期的炎症渗出或出血可导致胆固醇肉芽肿的形成。治疗主要是行上颌窦根治术，以达到永久治愈的目的。     

上颌窦炎性肌纤维母细胞瘤病例报告及文献回顾

摘要：目的探讨上颌窦炎性肌纤维母细胞瘤的临床表现,病理学特征、诊断、治疗及预后,旨在提高耳鼻咽喉科医生对该病的认识和治疗水平,并减少漏诊误诊。方法报告1例上颌窦炎性肌纤维母细胞瘤,并复习相关的国内外文献。结果CT扫描示窦腔可见低密度肿块影且突入眼眶,邻近窦壁明显受压、变薄,增强明显不均匀强化。MRI示类圆形稍高/等T2、T1信号肿块影,边界不清。病理示瘤组织主要由梭形肌纤维母细胞及大量炎性细胞组成。免疫组化中SMA、VIM等呈阳性,CK呈阴性。术后随访9个月,复查CT示左上颌窦窦腔未见明显新生物,呈术后改变。结论上颌窦炎性肌纤维母细胞瘤是非常罕见的,其诊断主要依靠病理及免疫组化检测。根治性手术切除仍为目前首选治疗方法,对于体积过大的血供占位病变,术前可辅助介入栓塞治疗。     

联合治疗晚期上颌窦癌121例报告

目的：探讨化疗,放疗与手术联合治疗晚期上颌窦癌的可行性。方法：术前放疗和手术６１例,术前化疗和手术６０例,放疗采和直线加速器和（或）＾６０Ｃｏ,剂量为４０￣６０Ｇｙ。化疗采用ＤＯＰ（顺氯氨铂加长春新碱加平阳霉素）方案。结果：放疗和手术组３年和５年生存率分别为３６．１％和３１．１％,化疗和手术组分别为３５％和３０％。结论;术前化疗加手术是治疗晚期上颌窦癌的可行性方法,且化疗能反复应用,提高手术效果。     

柯-陆手术进路上颌窦成形术的实验与临床研究

目的：探讨提高上颌窦疾病疗效的方法。方法：在动物实验的基础上,应用鼻内窥镜和显微外科技术,对６８例良性上颌窦病变,循柯－陆手术进路,行前壁环钻术和中鼻道窦造口术及骨壁修复成形术。结果：术后第５周,犬窦腔粘膜再生和修复较完全,前臂骨瓣成形骨痂愈合,临床随访１８￣４２个月（平均２８个月）中鼻道窦口通畅９６％,结论：表明上颌窦成形术在彻底清除病灶的基础上,恢复窦腔解剖结构,保持生理性引流通道,有利于术后     

上颌窦气化与牙源性上颌窦炎的相关性分析

目的 探讨上颌窦气化与牙源性上颌窦炎发病的关系.方法 回顾性分析牙源性上颌窦炎患者鼻窦CT中双侧牙槽突骨质厚度、牙槽突气化深度,冠状位上颌窦高度及矢状位对角线长度,观察牙源性上颌窦炎患者双侧上颌窦气化程度的差异.结果 牙源性上颌窦炎患者患侧上颌骨牙槽突厚度:(5.67±1.79)mm,健侧上颌骨牙槽突厚度:(7.88±...     

Paranasal sinus aspergilloma: a case report

Aspergilloma, though rare, is a benign condition of the paranasal sinuses affecting young males with reasonable morbidity. Besides diagnosis, optimal surgery and prolonged adequate medical therapy under vigilant supervision is mandatory to treat this condition effectively, We are presenting one such ease of aspergilloma who was appropriately managed.     

儿童上颌窦异位脑膜瘤4例报告并文献复习

目的：探讨儿童上颌窦异位脑膜瘤的临床表现及诊治方法。方法：对4例儿童上颌窦异位脑膜瘤的临床资料进行回顾性分析并复习文献。结果：4例患儿表现为进行性鼻塞,其中1例伴有眼球突出,临床检查4例于鼻腔外侧壁可见类球状新生物,黏膜光滑,质硬。CT检查显示,上颌窦鼻腔新生物高密度影,边界清楚,周围可见骨质吸收。治疗均于全身麻醉下手术切除,3例采用面中翻揭术,1例采用鼻侧切开术,随访4～6年无复发。结论：CT对上颌窦异位脑膜瘤的诊断有重要意义,完整切除肿瘤是治疗儿童上颌窦异位脑膜瘤的最佳方法。     

Undifferentiated sarcoma of the maxillary sinus: report of a rare case in an adult

A 51-year-old man complained of left facial swelling and recurrent nasal bleeding. A giant solid tumor in the left maxillary sinus was detected on head CT and MRI, and this tumor was destroying the maxilla and extending into the orbit, pterygoid muscle and posterior paranasal sinuses. The resected specimen consisted of spindle cells containing necrotic material. Histological examination revealed immature tumor cells, and immunohistological study of the tumor showed staining was only positive for vimentin. We accordingly diagnosed undifferentiated sarcoma in the maxillary sinus. Combination chemotherapy with vincristine, doxorubicin, cyclophosphamide/ifosfamide with mesna and etoposide was administered; however, the tumor was unresponsive and the patient died after around 3 months.     

Epithelial-myoepithelial carcinoma of the maxillary sinus: a rare case

Epithelial-myoepithelial carcinoma (EMC) is a rare tumor that commonly involves the salivary glands. EMC of the maxillary sinus is extremely rare. We describe here a case of a 50-year-old patient who presented with right cheek swelling for 7 years and bilateral nasal obstruction and right nasal bleeding for 3 months. A pinkish polypoidal mass was seen in the right nasal cavity. Computed tomography scan revealed an expansile soft tissue mass in the right maxillary sinus with erosion of all of its walls. Histopathological examination of the excised specimen confirmed myoepithelial carcinoma with positive reaction to S-100 and smooth muscle actin. Subsequently, the patient developed regional nodal metastasis in the neck for which neck dissection was performed. Histopathology of the neck dissection specimen revealed metastatic EMC. EMC is rare tumor and a diagnostic dilemma. It should be considered in cases showing dual tumor cell population with clear cell change in histopathology. Common differential diagnosis includes metastatic renal cell carcinoma, acinic cell carcinoma, adenoid cystic carcinoma, mucoepidermoid carcinoma, oncocytoma, and sebaceous carcinoma. Laryngoscope, 2012.     

A comparative study of the ciliary area of the maxillary sinus mucosa and computed tomographic images

The ciliary area of the maxillary sinus mucosa and coronal sinus computed tomographic (CT) scans were studied in 36 maxillary sinuses of 28 patients with chronic sinusitis. Tissue specimens allowed ciliary surfaces to be observed under scanning electron microscopy, allowing surfaces to be expressed in terms of ciliary area (CA) as the percentage of mucosal surface occupied by cilia. The opacity produced by mucosal swelling and secretion in the maxillary sinus on CT was assessed by two methods: Min’s and modified van der Veken’s methods. Both techniques indicated an inverse correlation between opacity of the maxillary sinus and CA. Our findings suggest that the opacity of maxillary sinus on CT could be a significant parameter for predicting the surface conditions of ciliated maxillary mucosa prior to sinus surgery. Received: 3 February 1997 / Accepted: 19 June 1997     

Respiratory epithelial adenomatoid hamartoma associated with inflammatory nasal polyposis: a case report

Respiratory epithelial adenomatoid hamartoma (REAH) is an uncommon benign lesion of the nasal cavity and paranasal sinuses. The etiology is unclear, however it is considered to be secondary to chronic sinonasal inflammation. Although it is rare, REAH should be taken into consideration in differential diagnosis of the nasal lesions. Complete surgical excision of the lesion is generally enough for the cure. A detailed pathological examination is necessary to prevent unnecessary surgical interventions. In this article, we present a 60-year-old female patient with REAH in the left nasal cavity associated with inflammatory polyp in the right nasal cavity.