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.     

鼻耳部砂粒性骨化性纤维瘤

目的澄清砂粒性骨化性纤维瘤（ｐｓａｍｍｏｍａｔｏｉｄｏｓｉｆｙｉｎｇｆｉｂｒｏｍａ，ＰＯＦ）的组织学特点、生物学特性、临床行为和骨化性纤维瘤、骨纤维结构不良的关系。方法对我院１９５６年６月～１９９６年１２月４０年期间的３１例ＰＯＦ的组织切片，临床和病理记录资料进行回顾性分析。１０例作网织纤维染色、Ｍａｓｏｎ三色染色（ＭＳ）和碱性磷酸酶免疫酶染色（ＡＰ），５例作波纹蛋白，结蛋白，上皮膜抗体和平滑肌肌动蛋白免疫组化染色。１例作了透射电镜。结果１１例完整标本有薄壁骨壳和大小不等的囊腔，触之有砂粒感。组织学上，肿瘤中心区有丰富的肿瘤性间叶细胞和大量的砂粒骨，无骨小梁。肿瘤和正常骨之间有“三带”（肿瘤反应性骨增生正常骨），反应性骨增生带可不明显，肿瘤附近骨组织有被吸收、消失乃致肿瘤进入软组织的现象，但无恶性浸润的性质。１２例复发。无转移。本瘤好发出血和囊性变。结论鼻耳部ＰＯＦ是生长缓慢的良性肿瘤，是不同于骨化纤维瘤和骨纤维结构不良的独立实体，因为有一定的侵蚀性，可复发，治疗为手术切除。     

鼻腔鼻窦青少年型骨化纤维瘤六例临床分析

目的 分析鼻腔鼻窦青少年骨化纤维瘤的临床特点,并探讨治疗方法。 方法 选取2015年5月至2017年12月治疗的6例鼻腔鼻窦青少年骨化纤维瘤,男4例、女2例,年龄2个月~12岁6个月,中位年龄6岁2个月。肿瘤发生于上颌窦1例,筛窦3例,蝶窦1例,额窦1例。患儿入院后均行手术治疗,1例患儿肿物累及视神经,为保留患儿视力行鼻内镜下肿物部分切除术,术后半年发现肿物累及视神经并广泛累及颅底,行第2次鼻内镜下肿物部分切除术,术后半年因肿物复发且累及范围广泛,在第3次手术时行右侧鼻侧切开联合鼻内镜下鼻-鼻窦骨化纤维瘤部分切除术。其余患儿均行鼻内镜下肿物切除术。除1例年龄为2个月的患儿未行导航CT检查外,患儿术中均采用美敦力FUSION ENT Image Guidance System电磁导航技术对肿物边缘予以定位。另有1例患儿因肿物位于蝶窦且有明确的滋养血管,鼻内镜术前1 d予以介入血管造影及栓塞术。患儿术后均定期随访,包括鼻内镜检查及鼻窦CT检查,了解患儿术区情况、症状是否缓解及有无并发症出现。 结果 6例患儿病理分型为砂砾样5例,小梁状1例。患儿均未失访,平均随访时间2.2年。其中1例复发,予以肿物部分切除,术后带瘤生存。其余患儿随访期内均未发现肿物复发且无并发症出现,患儿的原发症状均得到有效缓解。 结论 鼻腔鼻窦青少年骨化纤维瘤具有侵袭性生长和术后易复发的临床特点,手术是惟一有效的治疗方法。影像导航下鼻内镜手术是适合儿童的术式。     

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。     

18例鼻窦骨化纤维瘤的手术治疗探讨

 目的探讨鼻窦骨化纤维瘤的临床特点及手术治疗方案。方法回顾性分析郑州大学第一附属医院2011年01月～2017年06月治疗的18例鼻窦骨化纤维瘤患者的临床资料,其中男11例,女7例,年龄8-37岁,平均年龄15岁。15例经鼻内镜下行鼻窦骨化纤维瘤切除,3例经鼻内镜下联合头皮冠状切口入路手行鼻窦骨化纤维瘤切除。结果本研究18例患者,14例完全切除,4例部分切除。面部肿胀,眼球突出和移位,鼻塞,鼻出血和头痛症状均有不同程度的改善,嗅觉减退2例中1例恢复,1例无改善;视力下降5例,2例提高,余3例无改善,但未加重。未出现失明、脑脊液鼻漏、颅内感染和大出血等严重并发症。随访时间0.5～7年, 12例无复发,4例带瘤生存,2例复发。结论鼻内镜下及鼻内镜联合头皮冠状切口进路手术适合大部分鼻窦骨化纤维瘤患者手术,此手术经路具有保护鼻腔鼻窦结构、功能和面部美容等优点,但要求术者有较高内镜解剖知识和手术技能。     

An aggressive psammomatoid ossifying fibroma of the sinonasal tract: report of a case

Aggressive psammomatoid ossifying fibromas (APOFs) represent a subgroup of related fibro-osseous lesions that appears to be unique to the nasal cavity, paranasal sinuses, and orbit. These rare lesions are characterized by distinctive histomorphologic features and a tendency to affect younger patients. Histologically they are benign, but clinically they are locally aggressive. We report the case of a 15-year-old boy who had a large APOF in the left ethmoid and sphenoid sinuses. The location of this tumor made this case unusual.     

上颌骨成釉细胞纤维瘤1例

患者,女,22岁,以“右面部肿胀2个月”为主诉于2012年6月21日入院。专科查体：右侧面部膨隆,右上颌前庭沟膨隆,右侧硬腭膨隆（图1）,压痛（-）,上颌牙齿列齐,无缺损,无活动,无张口受限,眼球活动及视力正常,双侧鼻腔通畅。     

Aggressive pilomatrixoma of the infra-auricular area: a case report

Although pilomatrixomas are well known among dermatologists and dermatopathologists, head and neck surgeons confronted with these lesions in the infra-auricular region do not consider this benign neoplasm in the differential diagnosis. Aggressive pilomatrixoma is a benign tumor of the hair matrix cells affecting mainly children. Histologically, the border between aggressive pilomatrixoma and pilomatrix carcinoma is still not clear. We report the case of a 15-year-old Turkish boy suffering from an aggressive pilomatrixoma of the infra-auricular region and review the literature about this unclear entity.     

鼻-前颅底骨化纤维瘤的手术治疗

目的 探讨侵犯前颅底的鼻窦骨化纤维瘤的手术治疗。方法 回顾性分析6例侵犯前颅底的鼻窦骨化纤维瘤的手术方式，其中3例采用冠状切口加鼻侧切开，3例采用冠状切口加鼻内镜手术。结果 术后无并发症，随访1年6个月～7年无复发。结论 冠状切口加鼻侧切开术式能最大限度暴露病变，彻底切除肿瘤，减少并发症。冠状切口加鼻内镜手术术式不仅兼具上述特点，还可避免颜面部遗留手术瘢痕，符合微创和美容要求。     

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.     

Endoscopic resection of ossifying fibroma involving paranasal sinuses and the skull base in a series of 15 cases

Conclusion: The key technical challenges in the resection of OFs are rapid removal of tumors by image-guided navigation, determining the boundary of the resection and the proper control of blood supply through the anterior or posterior ethmoidal arteries.

Objective: This study aimed to analyze the clinical data of adult patients with paranasal ossifying fibromas involving the anterior skull base and orbit. The surgical technique and indications are also discussed.

Methods: This study reviewed the clinical data of 15 patients (age >16 years) who underwent resection of paranasal ossifying fibromas involving the anterior skull base and orbit by endoscopic surgery with an image guidance system between October 2006 and October 2014.

Results: The mean age of the 15 patients was 33.2 years (range?=?16–58 years). All tumors were completely resected via endoscopic surgery. Intra-operative cerebrospinal fluid (CSF) leaks (four cases) were repaired endoscopically. The mean follow-up duration was 43.1 months. One patient lost vision after surgery, recurrence was observed in two patients, one underwent a third excision 8 years after the second surgery, and the other exhibited residual osteoarthritis 3 years after the first surgery and remained under regular observation. One patient was lost to follow-up.     

A long standing foreign body in the ethmoid-a case report

Headache is the most common complaint in present Jay ENT practice, it happens to be the most frequent and misunderstood wmptom. Foreign bodies in the paranasal sinuses invariably pose challenges to the surgeon due to the complex anatomy. Here, we present a case report of an unusual long standing foreign body of 40 years, in the ethmoid, presenting headache as a feature, after 37 years.     

鼻腔鼻窦转移性肾透明细胞癌一例报道并文献综述

目的 探讨鼻腔鼻窦转移性肾透明细胞癌的临床特点及诊疗方法.方法 回顾性分析1例肾透明细胞癌转移至鼻腔鼻窦患者病历资料,并检索1993～2020年间国内外发表的相关文献,包括本例共有64篇文献76例患者纳入研究,总结其临床表现、诊断、治疗方法及预后.结果 76例中男61例,女15例.症状出现较多者为鼻出血58例、鼻塞25...     

Volumetric study in the development of paranasal sinuses by CT imaging in Asian: A Pilot study

Background and objectives

The volume of the air cavities in the paranasal sinuses is not only the simplest, but also the most important index for paranasal sinus evaluation. However, few volumetric studies have been performed in all age groups. The purpose of the current study was to outline the normal development of paranasal sinuses in all age groups, and to determine normal adult volumetric values by means of computed tomographic (CT) scan of paranasal sinus using volumetric procedures.

Materials and methods

A prospective volumetric CT study was conducted with 260 patients (520 sides) < 25 years of age by means of three-dimensional reconstruction.

Results

The frontal sinuses began to pneumatize at 2 years of age, exhibited a faster growth pattern between 6 and 19 years of age, and the mean volume after full growth was 3.46 ± 0.78 cm³. The maxillary sinuses were pneumatized at birth in all cases, exhibited a monomodal growth pattern increasing until 15 years of age, and the mean volume after full growth was 14.83 ± 1.36 cm³. The floor of the sinus was the same level as the floor of the nasal cavity was between 7 and 15 years of age. The ethmoid sinuses exhibited a faster initial tendency to increase until 7 years of age, were completed by 15-16 years of age, and the mean volume after full growth was 4.51 ± 0.92 cm³. The sphenoid sinuses exhibited a growth spurt between 6 and 10 years of age, were completed by 15 years of age, and the mean volume after full growth was 3.47 ± 0.93 cm³.

Conclusion

The results of this study are presented to provide the basis for an objective normal volume of sinus development and for studies involving diseases of the sinuses.     

儿童鼻腔巨大真性纤维瘤一例

患儿男,6岁,进行性右侧鼻腔阻塞3年,间断性少量鼻出血,伴右眼球渐突出,视力下降.于2005年9月20日以"鼻腔肿物"收入院.查体:颈部淋巴结无肿大,右面颊部隆起,右眼球向前外方突出,眼睑肿胀,睑裂变小,复视,右眼视力0.6,右鼻腔有淡灰白色肿物,质硬,基底广,不易出血,对血管收缩剂不敏感.CT影像示右侧鼻腔巨大占位性病变,鼻中隔受压移位.     

A case with sinonasal teratocarcinosarcoma in the nasal cavity and ethmoid sinus

Sinonasal teratocarcinosarcoma (SNTCS) is a rare and aggressive malignant neoplasm histologically characterized by the combination of one or more epithelial elements and mesenchymal components. We report a 61-year-old man with SNTCS involving left nasal cavity and ethmoid sinus. He complained of left epistaxis for 1 week. Computed tomography and magnetic resonance imaging revealed a soft tissue filling the left middle meatus and ethmoid sinus, and effusion in the left sphenoid sinus but no invasion to the orbit or skull base. Tumor was completely removed with lateral rhinotomy, and post-operative radiation therapy (Liniac 60 Gy) was performed. Follow-up examination for 3 years and 5 months after the radiation therapy has shown no evidence of recurrence or metastasis. This report describes his clinical course, etiology, diagnosis and management of SNTCS with a review of literature.     

Surgical treatment of primary tracheal dyskinesia in a 14-month-old child—Case report

The primary form of tracheal dyskinesia in early childhood is a rare congenital malformation of unknown origin. The degree of the posterior membranous tracheal wall involvement determines the intensity of obstruction and the severity of the clinical picture. The aim of this paper is to present a case of a 14-month-old child with severe tracheal dyskinesia that required surgical treatment. Fascia lata graft fixated with fibrin glue was used in strengthening the posterior tracheal wall. Three years following the surgery, the child is without breathing difficulties. In severe cases of primary dyskinesia, surgical treatment using fascia lata graft, fixated with fibrin glue is recommended in strengthening the posterior tracheal wall.