[我们治疗儿童先天性鼻中隔异位症的经验及各种治疗方法概述]。

Q3 Medicine
E V Molodtsova, A S Yunusov, N A Daikhes, D P Polyakov, A S Korobkin, O M Larina
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引用次数: 0

摘要

鼻蝶窦囊肿(先天性鼻中隔异位)是一种罕见的儿童先天性病变:根据文献研究鼻蝶形囊肿的临床表现、放射诊断方法和手术效果:2017年至2022年,在俄罗斯联邦医学生物局国家耳鼻咽喉科医学研究中心小儿耳鼻咽喉科对诊断为 "鼻背和鼻腔蝶形囊肿、鼻背表皮囊肿、胶质瘤、脑囊肿 "的病历进行了回顾性研究。病历按照病变性质、进行的成像技术、手术过程和获得的结果进行分析:共分析了 16 份病历,平均年龄为 4.5 岁(10 个月至 15 岁不等),在过去 5 年中诊断为 "鼻背和鼻腔蝶窦囊肿、胶质瘤、鼻背表皮囊肿、脑囊肿"。所有患者在术前都接受了磁共振成像(MRI)检查,14 名患者还接受了计算机断层扫描(CT)检查:结果:其中 7 名患者确诊为有瘘管的类皮样囊肿,3 名患者没有瘘管,3 名患者患有胶质瘤,1 名患者患有脑瘤,2 名患者患有表皮样囊肿。鼻背和鼻腔的蝶形囊肿瘘管开口位于鼻背上三分之一处的有 3 名患儿,位于中三分之一处的有 2 名患儿,位于下三分之一处的有 2 名患儿。文章对比国外学者的数据,提出了病变特点和手术治疗策略方案。术中,6 名患者出现颅内扩散。文章还介绍了治疗颅内扩散的各种手术方法,并对相应的文献进行了回顾。随访1至5年(平均3.5年),未发现复发或术后并发症:结论:鼻正中异位症是一种罕见的先天性畸形。术前准备应包括 CT 和 MRI,以评估病变并排除颅内扩散。手术方法直接取决于异位瘤的定位及其扩散情况。我们根据作者的方法对所有患者进行手术治疗后,均取得了良好的美容效果。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
[Our experience in the treatment of congenital nasal median heterotopias in children and an overview of various treatment tactics].

Dermoid nasal cysts (congenital nasal median heterotopias) are a rare congenital pathology in children.

Objective: Yo consider the clinical picture, methods of radiation diagnosis and to study the surgical results of a dermoid cyst of the nose according to the literature.

Materials and methods: A retrospective review of medical histories with the diagnosis of "Dermoid cyst of the back of the nose and nasal cavity, epidermal cyst of the back of the nose, glioma, encephalocele" was conducted from 2017 to 2022 in the Pediatric Otorhinolaryngological Department of the National Medical Research Center for Otorhinolaryngology of the Federal Medical-Biological Agency of Russia. The case histories were analyzed by the nature of the lesion, the imaging techniques performed, the course of the operation and the results obtained.

Material and methods: A total of 16 medical histories were analyzed, the average age was 4.5 years (range 10 months - 15 years), over the past 5 years with a diagnosis of "Dermoid cyst of the nasal dorsum and nasal cavity, glioma, epidermal cyst of the nasal dorsum, encephalocele". All patients underwent magnetic resonance imaging (MRI) in the preoperative period, 14 patients also underwent computed tomography (CT).

Result: Of these, 7 had a confirmed dermoid cyst with a fistula, 3 patients without a fistula, 3 patients had glioma, and 1 had encephalocele, 2 patients had an epidermoid cyst. A fistulous opening of the dermoid cyst of the nasal dorsum and nasal cavity was observed in the upper third of the nasal dorsum in 3 children, in the middle third in 2 patients and in the lower third in 2 children. The article presents a scheme for the characteristics of the lesion and the tactics of surgical treatment in comparison with the data of foreign authors. Intraoperatively, intracranial spread occurred in 6 patients. Various surgical approaches for intracranial proliferation and a corresponding literature review are also presented. Catamnestic follow-up ranged from 1 to 5 years (on average, 3.5 years), no relapses or postoperative complications were noted.

Conclusion: Nasal median heterotopias are a rare congenital anomaly. Preoperative preparation should include CT and MRI to assess the lesion and exclude intracranial spread. The surgical approach depended directly on the localization of heterotopia and its spread. All patients had a good cosmetic result after the surgical treatment performed by us according to the author's method.

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来源期刊
Vestnik otorinolaringologii
Vestnik otorinolaringologii Medicine-Otorhinolaryngology
CiteScore
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