鼻窦骨化纤维瘤的手术治疗

报告６例鼻窦骨化纤维瘤。４例行鼻侧切开术，１例行扩大鼻侧切开术，１例行鼻内窦镜手术，获得了良好的效果。本文分析研究鼻窦骨化纤维瘤的鼻窦ＣＴ及病理特点，总结探讨该病手术治疗方法，即根据病变范围的不同选择不同类型手术。     

鼻腔鼻窦骨化纤维瘤的螺旋CT诊断

目的探讨螺旋CT在鼻腔鼻窦骨化纤维瘤的诊断价值。方法回顾性研究本院行手术治疗并经病理确诊的鼻腔鼻窦骨化纤维瘤患者24例,分析其临床资料及螺旋CT影像学特征,探讨螺旋CT诊断程序。结果侵犯单个鼻窦的肿瘤12例,包括筛窦8例,上颌窦4例;其中6例伴有鼻腔侵犯。病变同时侵犯多个鼻窦和鼻腔者12例,包括上颌窦和筛实8例,筛窦和额窦4例。肿瘤的CT表现为鼻腔／鼻窦内单发类圆形或不规则形高密度肿块,部分区域可见低密度影,其周边显示完整的骨性包壳,呈膨胀性生长,周围组织受压变形但界限清晰。结论螺旋CT扫描是诊断鼻腔鼻炎骨化纤维瘤最常用和最有价值的影像学检查手段。     

发生于鼻根部的青少年型骨化纤维瘤临床分析与手术探讨

目的:分析发生于鼻根部的青少年型骨化纤维瘤的临床特点,并比较不同的手术方法.方法:对7例发生于鼻根部的青少年型骨化纤维瘤患者给予手术治疗,5例患者在神经导航引导下经鼻内镜行鼻根肿物切除,另2例患者行鼻小柱-鼻翼"蝶形"切口鼻根部肿物切除.术后定期随访,包括内镜检查和鼻窦CT扫描.结果:7例患者病理回报符合骨化纤维瘤.随...     

儿童鼻腔鼻窦骨化纤维瘤

目的提高儿童鼻腔鼻窦骨化纤维瘤诊治水平。方法1995年1月至2007年1月,对8例患儿的临床表现、治疗情况、病理检查及长期随访结果进行回顾分析并复习文献资料。结果本组8例患者中,男5例,女3例,年龄6～17岁,病程3个月～3年。肿瘤位于左侧面部4例,右侧面部4例。均行手术切除,鼻侧切开入路2例,内镜经鼻入路4例,犬齿窝入路配合鼻内镜手术2例。随访1．5-12年,6例无复发,术后半年复发1例,1年复发1例,均经再次手术完整切除。结论骨化纤维瘤是一种良性骨肿瘤,临床常表现为颌面部无痛性膨大。影像学呈膨胀性生长,与周围组织有蛋壳样边界。病理显微镜下,胶原纤维呈漩涡状分布,其间散在分布不规则钙化团块,病变与周围骨皮质分界清楚。鼻内镜或内镜辅助下微创手术是唯一有效的治疗方法。     

鼻腔鼻窦骨化纤维瘤9例

目的：探讨提高鼻腔鼻窦骨化纤维瘤诊治水平的途径。方法：回顾性分析9例鼻腔鼻窦骨化纤维瘤患者的临床资料。根据病变范围不同，其中3例选择上颌窦进路，将鼻腔上颌窦肿块完整切除；6例在全身麻醉下行颈侧切开术。结果：2例因手术切除不彻底，分别于术后8个月和9个月复发而再次手术，其余7例随访2～10年无复发，无并发症发生。结论：鼻腔鼻窦骨化纤维瘤是一种以青少年发病为主，具有局部侵袭性的良性肿瘤，临床症状、特别是CT扫描是临床诊断的基础，彻底切除肿瘤是惟一有效的治疗方法。     

儿童鼻窦-前颅底骨化纤维瘤1例

患者,女,14岁。因鼻塞、突眼伴视物模糊6个月于2003年8月12日入院。鼻窦CT扫描示：右侧筛窦及额窦实变,可见不规则分叶状囊性占位,肿块呈膨胀性生长,密度不均匀,病变累及并侵犯前颅底和右侧眼眶内侧壁,局部骨质破坏明显,并见软组织肿块影,CT值26～490HU,其内有程度不同的高密度钙化,周围组织受压变形,边界尚清晰。增强扫描：肿块密度轻度增高。临床拟诊：     

鼻窦骨化纤维瘤手术探讨

目的　探讨鼻窦骨化纤维瘤的手术进路 ,分析各种手术的方法和特点。方法　回顾性分析我院 1994年 8月～ 2 0 0 1年 7月治疗的鼻窦骨化纤维瘤 35例的临床资料。结果　 35例中男 2 3例 ,女 12例 ,年龄 2～ 4 5岁 ,平均 17 1岁。手术方式包括鼻侧切开手术、鼻内镜下手术、冠状切口颅骨切开手术 (包括冠状切口颅骨切开联合鼻内镜下手术及冠状切口颅骨切开联合鼻侧切开手术 )、Caldwell Luc进路手术。鼻内镜下手术 2 2例 ,彻底切除 8例 ,部分切除 14例。 2例在影像导航辅助下手术。鼻侧切开手术 6例 ,彻底切除 4例 ,部分切除 2例。冠状切口颅骨切开手术 5例 ,彻底切除 2例 ,部分切除 3例 ,有 2例联合鼻内镜下手术 ,1例联合鼻侧切开手术。Caldwell Luc进路手术 2例 ,均为部分切除。 35例患者随访 33例 ,失访 2例 ,平均随访时间 3 5年。结果 14例无复发 ,14例带瘤生存 ,5例复发后再次手术。结论　鼻窦骨化纤维瘤手术进路的选择主要依据病变范围 ,同时要考虑器官结构的功能、美容、手术的难易程度以及术者的经验和习惯等。     

鼻窦骨化纤维瘤手术探讨

目的 探讨鼻窦骨化纤维瘤的手术进路，分析各种手术的方法和特点。方法 回顾性分析我院1994年8月～2001年7月治疗的鼻窦骨化纤维瘤35例的临床资料。结果 35w例中男23例，女12例，年龄2～45岁，平均17．1岁。手术方式包括鼻侧切开手术、鼻内镜下手术、冠状切口颅骨切开手术(包括冠状切口颅骨切开联合鼻内镜下手术及冠状切口颅骨切开联合鼻侧切开手术)、Cadwell-Luc进路手术。鼻内镜下手术22例，彻底切除8例，部分切除14例。2例在影像导航辅助下手术。鼻侧切开手术6例，彻底切除4例，部分切除2例。冠状切口颅骨切开手术5例，彻底切除2例，部分切除3例，有2例联合鼻内镜下手术，1例联合鼻侧切开手术。Cadwell-Luc进路手术2例，均为部分切除。35例患者随访33例，失访2例，平均随访时间3．5年。结果 14例无复发，14例带瘤生存，5例复发后再次手术。结论 鼻窦骨化纤维瘤手术进路的选择主要依据病变范围，同时要考虑器官结构的功能、美容、手术的难易程度以及术者的经验和习惯等。     

鼻窦骨化纤维瘤：附9例报告并文献复习

报告鼻窦骨化纤维瘤9例,并就有关的一些临床问题加以复习、探讨。精确判定该瘤的发生部位不易,文中概以受损害最严重的鼻窦作为原发部位叙述。本病对周围骨质的破坏能力甚大,颅底受破坏的程度往往出人意料,故认为术前X线检查颅底应列为常规。彻底手术治疗是唯一有效手段,手术径路视病情选择,过大肿瘤可分块切除。     

Aggressive psammomatoid ossifying fibroma in a 3-month-old boy—A case report

Aggressive psammomatoid ossifying fibroma (APOFs) is a benign mesenchymal tumor of the bone with a large growth potential, occurring usually in young adolescents and children. In this case report we are presenting a 3-month-old boy who was diagnosed with an aggressive psammomatoid ossifying fibroma of the nose and paranasal sinuses. In this age early diagnosis is difficult and may results in misdiagnosis such as chronic rhinitis. Endoscopic approach was chosen to remove the tumor. This case report demonstrates that complete endoscopic removal of large tumor involving nasal cavity and paranasal sinuses is effective, though technically challenging.     

鼻腔鼻窦恶性黑色素瘤23例临床分析

探讨鼻腔鼻窦恶性黑色素瘤的临床特征、诊断、治疗方法及预后,以提高对该病的诊疗水平。     

Juvenile psammomatoid ossifying fibroma in paranasal sinus and skull base

Conclusion: The endoscopic transnasal approach with IGS is a safe and effective technique, allowing completely resection of JPOF, with minimal morbidity and recurrence.

Objectives: JPOF is a benign but locally aggressive fibro-osseous lesion. This study presents a series of JPOF cases, involving anterior skull base and orbit, treated by endoscopic transnasal approach with image guidance system (IGS) to resect the mass completely.

Method: This study retrospectively reviewed the clinical presentations, surgical procedures, and complications of 11 patients with JPOF who were treated by endoscopic approach from May 2009 to April 2014. All patients were followed by endoscopic and CT scan evaluations during follow-up.

Results: All of the 11 cases were boys, with a mean age of 11.8 years (range?=?6–17 years). The size of mass in the paranasal sinus ranged from 2.5–4.6?cm in greatest dimension (mean?=?3.7?cm), and the medial orbital wall and cranial base were involved in all patients. All 11 patients received successful operation and were relieved from symptoms without mortality and major complications. During follow-up (range from 17–67 months; mean follow-up?=?25.8 months), only one patient was recurrent in local position. The skull base partial resected during surgery was found to rebuild after 1 year.     

鼻内镜下鼻腔成形术治疗结构性鼻炎

目的:探讨鼻内镜下治疗结构性鼻炎的手术方法和疗效。方法:对84例结构性鼻炎患者行鼻内镜下鼻腔成形术。包括:①三段法下鼻甲功能性部分切除;②中鼻甲成形;③窦口鼻道复合体功能性切除;④鼻中隔黏膜下矫正。手术结合患者主诉症状、鼻内镜检查和鼻窦CT分析,将上述各个单一手术进行组合,制定个性化方案进行手术。结果:术后随访8~12个月,平均10个月。痊愈59例(70.24%),有效21例(25.00%),无效4例(4.76%),总有效率95.24%。结论:结构性鼻炎是由于鼻腔存在多种结构异常而引起功能异常的一类疾病。鼻内镜下鼻腔成形术是对双侧鼻腔进行统一的功能性矫正,恢复鼻腔对称性整体结构的手术,应进行统一规范。     

鼻腔鼻窦恶性黑色素瘤11例临床分析

目的 探讨鼻腔鼻窦恶性黑色素瘤患者的临床特点、诊断及治疗方法。方法 回顾分析本科2000年1月～2011年11月收治的11例鼻腔鼻窦恶性黑色素瘤患者的临床资料。结果 11例中男7例,女4例, 46～82岁,平均65.7岁。采用手术+放疗治疗7例,手术+化疗2例,单纯手术1例,单纯放疗1例。术后1、2、3年生存率分别为81.82%、36.37%、9.09%。免疫组化对恶性黑色素瘤的诊断有重要价值。结论 鼻腔鼻窦恶性黑色素瘤临床少见、发展快、易复发、预后差。早期诊断和合理治疗是提高疗效的关键。     

Mucosal melanoma of the nasal cavity and paranasal sinuses

Mucosal melanoma of the nasal cavity and paranasal sinuses is a rare disease, but its incidence appears to be increasing. The mean age at diagnosis is between 65 and 70 years. Unilateral nasal obstruction and epistaxis are the most common presenting complaints. Melanoma arises in the septum or lateral wall of the nasal cavity in the great majority of cases. The histological diagnosis is based on specific immunohistochemical labelling and is usually established at an advanced stage of disease: stage T3 or T4 tumours according to the 7th edition of the American Joint Committee on Cancer (AJCC) classification of tumours. First-line treatment consists of surgery. The place of intranasal endoscopic surgery remains controversial due to the difficulty of controlling surgical margins and should be reserved for experienced teams. Adjuvant radiotherapy is usually performed due to its efficacy on local and regional disease control. Five-year overall survival of mucosal melanoma of the nasal cavity and paranasal sinuses in the most recent series does not exceed 40%. Local recurrence is observed in about 50% of cases and metastatic disease is common. The quality of initial tumour resection with negative surgical margins is the most important prognostic factor for tumours confined to the nasal cavity. Hopes for improvement of survival are based on early diagnosis, progress in radiotherapy techniques and cell and gene therapy that are currently under evaluation.     

A huge chondromyxoid fibroma of the nasal cavity in a newborn baby

Chondromyxoid fibroma is a rare benign tumor that usually occurs in the long bones. A 2-month newborn presented with huge masses in the both nasal cavities, which turned out to be chondromyxoid fibroma. The masses originated from both inferior turbinates. Total turbinectomy on the left side and submucosal mass excision on the right side were performed. No recurrence or new lesion was observed during the 2 years of follow up. We report here on a rare case of nasal cavity chondromyxoid fibroma in a neonate and we review the relevant literature.