颌面部骨纤维异常增殖症34例临床分析

目的：分析颌面部骨纤维异常增殖症（fibrous dysplasia,FD）的临床特点、影像学表现与临床相关因素的关系。方法：复习34例FD患者的临床资料并进行随访,对照分析单骨型、多骨型影像学表现特点。结果：34例患者,单骨型27例（79.4%）,多骨型7例（20.6%）。FD在影像学上多见毛玻璃样型,边界清晰或不清晰。入院时为复发病人共9例,多发生于青春期之前,经手术治疗后未出现再次复发。术后随访3个月至6年,平均4年,所有伤口愈合良好出院,15例失访,仅1例出现术后1年半复发。结论：FD是一种纤维骨性病变,颌面部为好发部位之一。此病无性别差异,CBCT能为FD诊断分析提供较准确的影像学证据。手术方式主要为颌面部骨改形术,手术宜在20岁后进行。

Clinical Analysis of 34 Patients with Fibrous Dysplasia of Maxillofacial Bone

Objective： To analyze the relationship between the clinical manifestation and radiographic features,of fibrous dysplasia and clinical related factors.Methods： Clinical data of 34 patients with fibrous dysplasia were retrospectively reviewed.The radiographic features of monostotic form FD and polyostotic form FD were compared.Results： Twenty-seven（79.4%） of total thirty-four patients were of monostotic form and seven（20.6%） were of polyostotic form.The radiographic features of FD were ＂ground-glass＂ pattern with opaque or clear rim.9 patients were with recurrent lesions at their first visit to our hospital,and the recurrence risk of fibrous dysplasia following curettage was higher in patients prior to puberty than that in adults.The duration of follow-up period averaged 4 years（3months to 6 years） and recurrence was observed in 9 patients with recurrent lesions.15 patients had lost to follow-up.One patient was with recurrent lesions at 1.5 years after the surgery.No recurrence happened again in the 9 recurrent patients.Conclusion： FD is a fibro-osseous lesion affecting maxillofacial region which has no gender predilection.CBCT could offer accurate radiographic evidence for clinical diagnosis.Most of the 34 patients ware accepted maxillofacial bone remodeling plastic surgery.Delay in surgery until after 20 years is recommended.