Clinical analysis and surgical discussion of juvenile ossifying fibroma in nasal root
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摘要: 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。随访6~45个月，无复发和明显的手术并发症。结论 手术是唯一有效的治疗手段，神经导航引导下鼻内镜肿瘤切除和鼻小柱-鼻翼“蝶形”切口肿瘤切除都是有效可行的手术方案，外鼻蝶形切口手术出血少、时间短，但术后鼻面部会出现轻度肿胀，鼻内镜损伤相对更小。Abstract: Objective To analyze the clinical features of juvenile ossifying fibroma in nasal root and to compare different surgical methods.Methods Seven cases of juvenile ossifying fibroma occurring in the nasal root were treated via surgery, 5 cases were resected under nasal endoscopy guided by Image Guidance System-based electromagnetic navigation, and 2 cases were resected by lateral nasal butterfly incision. Postoperative follow-up included endoscopy and CT scan of the sinuses.Results The pathological results of 7 patients were consistent with juvenile ossifying fibroma. Follow-up period ranged from 6 to 45 months, and there were no recurrence or surgical complications.Conclusion Surgery is the only effective treatment. Endoscopic sinus surgery with image navigation and lateral nasal butterfly incision resection has been deemed available. The external nasal butterfly incision has less bleeding and shorter operation time, but with mild nasal face swelling after surgery, and nasal endoscopy is a surgical method with less damage.
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Key words:
- juvenile ossifying fibroma /
- nasal root /
- surgical procedures, operative
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表 1 7例JOF患者的临床资料
例序 年龄/岁 病程/年 性别 主要症状 治疗方式 病理 随访时间/月 1 15 1 女 鼻根部无痛性肿胀 神经导航引导下鼻内镜肿瘤切除 小梁状 12 2 32 10 男 鼻背部隆起 神经导航引导下鼻内镜肿瘤切除 小梁状 36 3 17 3 女 鼻根部无痛性肿胀 神经导航引导下鼻内镜肿瘤切除 砂砾状 27 4 22 8 男 鼻根部隆起 神经导航引导下鼻内镜肿瘤切除 砂砾状 45 5 13 1 男 鼻背部隆起 神经导航引导下鼻内镜肿瘤切除 小梁状 16 6 18 3 女 鼻根部无痛性肿胀 鼻小柱-鼻翼“蝶形”切口肿瘤切除 小梁状 6 7 21 5 女 鼻根部无痛性肿胀 鼻小柱-鼻翼“蝶形”切口肿瘤切除 小梁状 12 
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