30例颌面部骨纤维异常增殖症诊治的临床分析

目的：总结颌面部骨纤维异常增殖症（fibrous dysplasia,FD）的临床特征、诊断和治疗经验。方法：对30例FD临床表现、X线影像学诊断和治疗进行回顾分析,并通过随访观察手术效果。结果：本病多发于青少年,病程较长,发育成熟后大多病例可停止发展。本组30例患者中20岁之前发病者占83.3%。根据临床和X线平片检查,单侧下颌FD10例;单侧上颌骨、颧骨和上颌骨、额骨、颞骨、顶骨、腭骨、蝶骨FD共23例（含上颌下颌同时发病者3例）。X线分型毛玻璃型14例（46.6%）,囊样型与硬化型各4例（13.3%）,混合型8例（26.6%）。全部病例均行铲除或磨削术,伤口一期愈合。随访2～5年,效果满意21例,较满意5例,不满意4例,满意度为86.7%。结论：对未成年患者应定期临床X线和核素检测观察。主张保守性手术治疗,力荐微创磨削术。

Clinical Analysis of 30 Patients with Fibrous Dysplasia of Maxillofacial

Objective：To summary the clinical manifestation,diagnosis,therapy of fibrous dysplasia（FD）on maxillofacial region.Methods：The clinical manifestation,radiological diagnosis and therapy were analyzed retrospectively.We observeb the operation effects.Results：This diseases was multiple in adolescents and had a long course.And they would stop after maturation.The incidence was 83.3% before 20year-old in 30 cases.Under inspection of clinical and X-ray diagnosis,10FD was in unilateral mandible,23FD was in unilateral maxillary,zygomaticomaxillary,temporal,frontale,temporal,parietale,palatum and sphenoid.Radiological classification：＂groundglass＂pattern 14cases（46.6% ）,cyst pattern 4cases（13.3% ）,hardened pattern 4cases（13.3% ）,hybrid pattern 8 cases（26.6% ）.All patients were follow-up.The satisfaction was 86.7% .Conclusion：The observe and radionuclide imaging in impuberism patients must be periodic carried out.Conservation surgical treatment was asserted.Microlesion surgery grinded ostectomy were recommended.