开窗减压术联合囊肿塞在颌骨囊肿治疗中的应用

目的:探讨开窗减压术联合囊肿塞在颌骨囊肿治疗中的应用,并评价其疗效。方法:对35例较大颌骨囊肿患者采用开窗减压术,吸除囊内容物,保留其余囊壁,制作囊肿塞,维持囊肿造瘘口引流通畅,并保持囊腔内清洁。术后定期复查和随访。结果:开窗减压术联合囊肿塞能够有效治疗颌骨囊肿,大大降低颌骨囊肿治疗中的手术创伤,保存颌骨及牙齿,维持颌面部外形和生理功能,是一种简便、有效的颌骨囊肿治疗方法。     

复发舌前腺囊肿的手术治疗

目的探讨复发舌前腺囊肿的病因和临床治疗方法。方法对20例复发舌前腺囊肿采取囊肿及同侧或双侧舌前腺完整摘除的手术方式进行治疗。结果 20例患者术后均I期愈合出院,术后随访6个月无复发。结论舌前腺有其自身的解剖生理特点,舌前腺囊肿不宜按一般黏液囊肿治疗原则进行,舌前腺囊肿及同侧或双侧舌前腺完整摘除是治疗舌前腺囊肿的可靠手段。     

舌下腺囊肿35例手术治疗总结

目的:观察舌下腺囊肿手术治疗后出现的并发症及复发现象。方法:对35例舌下腺囊肿手术治疗的病例 进行回顾性分析。结果:2例并发颌下腺炎,1例颌下腺导管断裂,1例囊肿复发,1例切口囊肿。结论:舌下腺囊 肿手术治疗存在颌下腺炎等并发症,未完全摘除舌下腺可引起舌下腺囊肿复发。     

囊肿塞在颌骨囊肿开窗减压术中的应用

囊肿塞是颌骨囊肿进行开窗减压术治疗中常用的辅助治疗器具,近年来,随着材料和技术的发展,不同形式的囊肿塞层出不穷。本文回顾了目前临床常见囊肿塞的种类、制作方法及其适应证,探讨了各类囊肿塞在制作及应用过程中的优缺点。     

舌下腺囊肿手术的疗效与并发症

手术是舌下腺囊肿的主要治疗方法。目前,对于舌下腺囊肿治疗最佳术式的选择尚无一致意见。袋形术创伤较小,常作为舌下腺囊肿的首选治疗方法,特别是患儿。然而,常规的袋形术复发率高,并可能因口内型囊肿治疗后复发而成为口外型病变。由于对发病原因认识不足,产生多种不同的手术方式或径路用于口外型舌下腺囊肿的治疗。经口内径路切除舌下腺并排空囊液的术式,广泛应用于各型舌下腺囊肿,成功率高。由于舌下腺囊肿手术的术野较小,局部解剖结构复杂,可能发生多种并发症,如舌神经损伤、下颌下腺导管损伤、出血与血肿等。文章结合文献复习和作者的经验,就舌下腺囊肿常用手术的疗效及并发症的预防做一概述。     

舌下腺囊肿的非手术治疗

舌下腺囊肿是一种常见的唾液腺囊肿，有多种治疗方法。尽管舌下腺及囊肿摘除术是目前临床上常用的方法，但为了避免手术的并发症，舌下腺囊肿的非手术治疗受到越来越多学者的关注。文章就舌下腺囊肿的硬化治疗、激光治疗及口服药物治疗等做一综述。     

颌骨囊肿100例临床总结

目的:总结颌骨囊肿的诊治经验。方法:回顾分析我科100例颌骨囊肿病例,按性质、大小分类,分别给予不同的治疗方法,对诊治经验进行临床总结。大型囊肿35例(包括5例角化囊肿)均采取开窗减压术加二期刮除术,并非颌骨方块切除;中型囊肿采取囊肿刮除术;小型囊肿采取根管治疗术。结果:5年随访均未复发,治愈率90%以上。结论:在治疗颌骨囊肿时,应根据其类型、病变部位和范围,以及患者的年龄和身体状况选择不同的术式。     

舌下腺囊肿的手术治疗

目的探讨舌下腺囊肿诊断,分析术后并发症的原因及预防。方法回顾性分析92例舌下腺囊肿手术治疗的临床资料。结果92例舌下腺囊肿中舌下型69例,口外型16例,哑铃型7例。误扎颌下腺导管导致慢性颌下腺炎1例,1年后摘除颌下腺;颌下腺导管流脓经反复治疗未愈半年后作颌下腺摘除1例;术后舌下腺囊肿复发2例。结论舌下腺手术治疗存在颌下腺炎、颌下腺导管误伤等并发症,单纯行舌下腺囊肿摘除可引起舌下腺囊肿的复发,手术完整摘除舌下腺是治疗舌下腺囊肿复发的关键。     

32例根尖囊肿的保守治疗临床疗效观察

目的：观察根尖囊肿保守治疗的临床疗效。方法：采用根管引流、龈瘘扩开、囊肿搔刮及囊腔内无水酒精注入,加上根管治疗,根管充填剂适当超填等方法保守治疗根尖囊肿。结果：32例根尖囊肿经保守治疗后,痊愈25例（占78.2%）、进步5例（占15.6）、失败2例（占6.3）。结论：保守治疗能治愈大部分根尖囊肿病例。     

舌下腺摘除治疗舌下腺囊肿的体会

在涎腺中所发生的囊肿性病变,以舌下腺囊肿较为常见和多发,其治疗需摘除患侧舌下腺及囊肿。从1990年—1995年我院共对13例舌下腺囊肿病患行手术治疗,效果良好,本文就治疗体会报道如下。     

A chylous cyst at the right base of the neck

A case is presented of a cystic lesion, which presented at the base of the right side of the neck. The lesion was more obvious on forced expiration. Aspiration revealed chylous fluid and a Magnetic Resonance Imaging (M.R.I.) scan revealed a well-circumscribed cystic lesion with no deeper extension. So far, this chylous cyst has not required treatment, but is being kept under regular review.     

Octreotide for Conservative Management of Intractable High Output Post Operative Chylous Fistula: A Case Report

A case of high output post neck dissection chylous fistula is presented, which was successfully managed conservatively with octreotide; a long acting somatostatin analogue. Routine measures had failed, and secondary complications precluded thoracoscopic ligation. We discuss the spectrum of problems associated with chylous fistula and review the rationale behind the use of octreotide.     

Lebensbedrohliche und letale Komplikationen der Neck dissection

Background. Between 1990 and 1999, 395 neck dissections were performed in 357 patients: 195 left-sided (105 of these radical) and 200 right-sided (107 of these radical). Life-threatening complications occurred in four cases and two patients died. Case reports. After left-sided radical neck dissection with chylous fistula, a chylothorax resulted, which could not be controlled in spite of chest tube drainage and thoracotomy so that the 75-year-old female patient died 30 days postoperatively. A 66-year-old man died 35 days after a functional neck dissection of the left side because of extreme chylous flow of up to 7 l/day in spite of parenteral nutrition, local surgical revision, and intrathoracic ligation of the thoracic duct. Undetected cirrhosis of the liver was regarded to be the reason for this extremely increased lymph flow. In a 63-year-old man, a jugular foramen hemorrhage during radical neck dissection could only be managed after 3 h and approximately 6 l of blood loss. In a 66-year-old man, a discrete injury of the pleura led to cardiovascular failure due to a tension pneumothorax with mediastinal shift about 45 min later, which required immediate chest tube placement. Discussion. In none of these unusual cases, which accounted for 1% of all evaluated interventions, had the patients been informed about the observed complication. However, no legal consequences resulted. Nevertheless, dramatic courses of chylous fistulas and rare complications should be considered both forensically when seeking informed consent and clinically.     

High output chyle leak after neck surgery: the role of video-assisted thoracoscopic surgery

Injury to the thoracic duct leading to formation of a chylous fistula is an infrequent but serious complication of major neck surgery that can result in a prolonged stay in hospital, and may lead to fluid, electrolyte, protein, and immune disturbances. Healing can also be impaired. We describe a case where an excessive chylous leak also contributed to the failure of two free flaps in the same patient, and we make recommendations regarding management of patients with free tissue transfer where this complication arises.     

颈淋巴清扫术后乳糜漏2例报告

目的:探讨颈淋巴结清扫术后乳糜漏的治疗方法。方法:回顾性分析口腔颌面部恶性肿瘤颈淋巴结清扫术后2例乳糜漏患者的临床资料。对2例患者先进行保守治疗,禁食,局部加压包扎,持续强负压吸引(压力一般在-0.02～-0.06 MPa之间)。其中1例强负压吸引时最大引流量达2 100 mL/d,局部加压包扎13 d无效后,再次手术结扎左胸导管。结果:1例乳糜漏经强负压吸引、加压包扎等处理1 d后治愈。另1例经加压包扎13 d无效,经胸导管结扎后2 d治愈。结论:及早发现颈淋巴结清扫术后乳糜漏,强负压吸引,适当加压包扎是治疗乳糜漏较为安全有效的方法,对于引流量超过500 mL/d者,应尽早打开缝扎淋巴导管。     

Lymphoepithelial cyst of the upper neck: report of a case

A case of lymphoepithelial cyst of the upper neck is presented. The patient was a 77-year-old woman. After her lesion was extirpated under clinical diagnosis of salivary gland tumor, identified as lymphoepithelial cyst (so-called branchial cyst). Histopathologically salivary gland was observed in the cyst wall composed of lymphoid tissue and was demonstrated highly active amylase-enzyme (S type) in the cyst fluid. These findings are convicted that our case originates ductal epithelium entrapped in cervical lymph node (inclusion theory of Bhaskar).     

新生儿巨大鳃裂囊肿合并感染1例报告

鳃裂囊肿是一种较少见的位于面颈侧方的先天性囊肿：作者报道1例新生儿巨大鳃裂囊肿合并感染病例．于出生后第17天行手术摘除，随访2a，效果良好，无复发。     

60例甲状舌管囊肿临床分析

目的探讨甲状舌管囊肿临床流行病学特点以提高手术治疗效果。方法对60例甲状舌管囊肿的临床表现、病理特点和治疗效果进行回顾性分析。结果甲状舌管囊肿以儿童好发,女性多于男性,舌骨及舌骨以下水平多见;多数甲状舌管囊肿位于颈正中线附近,极少数表现为颌下囊肿;囊肿以单个为主,少数表现为多个囊肿;多数病例术后可探查到管状物或条索状物。甲状舌管囊肿病理组织学表现呈多样性特征,治疗不当易复发。结论甲状舌管囊肿的临床表现及病理特点均表现为多样性特征,手术不当易复发。     

First brachial cleft cyst in the parotid area

A first brachial cleft cyst was detected in the parotid area of a 66-year-old Japanese man complaining of swelling in the left upper neck. Although the lesion was suggestive of a cyst, based on computed tomography and magnetic resonance imaging, the lesion was misdiagnosed as a benign tumor, because it was thought to localize to the parotid and most lesions occurring in the parotid gland are tumors. The histopathological diagnosis was a first brachial cleft cyst or a so-called lymphoepithelial cyst. This case demonstrates that it may be difficult to differentiate a cyst from a benign tumor in the parotid area.     

甲状舌管囊肿合并遗传性凝血因子V缺乏症1例报告

甲状舌管囊肿（TGDC）是常见的颈部畸形,多发生于1~10岁的儿童,也可见于成人,主要由胚胎时期甲状腺下移过程发生障碍导致;可异位于下降路线上的任何一处,手术治疗是其主要治疗方法。凝血因子V（FV）缺乏症是一种罕见的出血性疾病,分为遗传性FV缺乏症（FVD）及获得性FV缺乏症（AFVD）。本文报告1例45岁颈部肿物女性患者,偶然被诊断为FVD,经手术治疗切除颈部肿物,病理诊断为甲状舌管囊肿。患者手术前、后输注新鲜冰冻血浆（FFP）,手术顺利,术后恢复良好。