-
摘要: 报告13例儿童鼻部实质性肿物,其中鼻中隔血管瘤3例,上颌血管瘤2例,鼻婴儿纤维瘤1例,鼻腔及鼻窦成骨细胞瘤1例,鼻咽淋巴瘤2例,上颌淋巴瘤1例,鼻咽横纹肌肉瘤1例,上颌鳞状细胞癌1例,鼻咽鳞状细胞癌1例。所有患儿均采用手术治疗,1例鼻腔婴儿纤维瘤,2例鼻咽淋巴瘤,1例鼻咽横纹肌肉瘤,1例鼻咽癌和1例上颌癌术后接受放疗和化疗。本组病例显示儿童鼻部较为常见的实质性肿物是血管瘤,其中有2例鼻部具侵袭性的良性肿瘤,分别为1例鼻腔婴儿纤维瘤和1例鼻腔骨母细胞瘤。鼻内镜下肿物切除合并功能性鼻内镜手术是治疗该区域肿物的主要手段,疗效显著。儿童鼻部恶性肿瘤并不少见,以淋巴瘤和横纹肌肉瘤常见,鼻咽癌和上颌窦癌亦有散发病例。Abstract: In this article we reported 13 cases of the substantial nasal mass in children. Among 13 these patients, 3 cases were septal hemangioma, 2 cases were maxillary hemangioma, 1 case was nasal infantile fibromatosis, 1 case was osteoblastoma of the nasal cavity and sinuses, 2 cases were lymphoma of nasopharynx, 1 case was maxillary lymphoma, 1 case was rhabdomyosarcoma of nasopharynx, 1 case was maxillary squamous-cell carcinoma, 1 case was squamous-cell carcinoma of nasopharynx.All 13 cases were treated with surgery, 1 case with nasal infantile fibromatosis, 2 cases with lymphoma of nasopharynx, 1 case with rhabdomyosarcoma of nasopharynx, 1 case with nasopharyngeal carcinoma and 1 case with maxillary carcinoma were taken postoperative radiotherapy and chemotherapy. The most common substantial nasal mass in children was hemangioma. This study included 2 cases with nasal invasive benign tumors, 1 case with nasal infantile fibromatosis and 1 case with osteoblastoma of the nasal cavity and sinuses. The functional nasal endoscopic surgery of mass resection was the main method for the treatment of mass in this area and had achieved satisfied effect. Lymphoma and rhabdomyosarcoma were the most common nasal malignant tumor in children. Nasopharyngeal carcinoma and maxillary carcinoma were not uncommon.
-
Key words:
- children /
- nasal tumor /
- endoscopic surgery
-
表 1 儿童鼻腔肿物发病情况
X ±S 类别 疾病 例数 平均年龄/岁 良性肿瘤 鼻中隔血管瘤 3 8.67±3.59 上颌窦血管瘤 2 具侵袭性的良性肿瘤 鼻腔骨母细胞瘤 1 5.75±5.19 鼻腔婴儿纤维瘤 1 恶性肿瘤 鼻咽部淋巴瘤 2 8.17±3.29 鼻咽癌 1 上颌窦鳞状细胞癌 1 鼻咽部横纹肌肉瘤 1 上颌窦淋巴瘤 1 -
[1] Rodriguez DP, Orscheln ES, Koch BL. Masses of the Nose, Nasal Cavity, and Nasopharynx in Children[J]. Radiographics, 2017, 37(6): 1704-1730. doi: 10.1148/rg.2017170064
[2] 鲍晓林. 小儿鼻咽部肿物5例报告[J]. 临床耳鼻咽喉科杂志, 2002(11): 635-635. doi: 10.3969/j.issn.1001-1781.2002.11.034
[3] Mannan AA, Ray R, Sharma SC, et al. Infantile fibromatosis of the nose and paranasal sinuses: report of a rare case and brief review of the literature[J]. Ear Nose Throat J, 2004, 83(7): 481-484. doi: 10.1177/014556130408300715
[4] Hicks KL, Moe KS, Humphreys IM. Bilateral Transorbital and Transnasal Endoscopic Resection of a Frontal Sinus Osteoblastoma and Orbital Mucocele: A Case Report and Review of the Literature[J]. Ann Otol Rhinol Laryngol, 2018, 127(11): 864-869. doi: 10.1177/0003489418798388
[5] 李薇, 赵曼丽, 郑惠文, 等. 婴儿指趾纤维瘤病一例[J]. 中国麻风皮肤病杂志, 2020, 36(8): 490-492. https://www.cnki.com.cn/Article/CJFDTOTAL-MALA202008012.htm
[6] Peroša N, Urban i J, Felbabic ' T, et al. Desmoid-type fibromatosis of paranasal sinuses with intracranial extension in a child-acase-based review[J]. Childs Nerv Syst, 2021, 37(12): 3673-3680. doi: 10.1007/s00381-021-05200-0
[7] Caltabiano R, Serra A, Bonfiglio M, et al. A rare location of benign osteoblastoma: case study and a review of the literature[J]. Eur Rev Med Pharmacol Sci, 2012, 16(13): 1891-1894.
[8] Cekic B, Toslak I E, Yildirim S, et al. Osteoblastoma originating from frontoethmoidal sinus causing personality disorders and superior gaze palsy[J]. Niger J Clin Pract, 2016, 19(1): 153-155. doi: 10.4103/1119-3077.173706
[9] 陆颖霞, 林枫, 谷庆隆, 等. 儿童变应性真菌性鼻窦炎病例分析及文献回顾[J]. 临床耳鼻咽喉头颈外科杂志, 2022, 36(4): 247-252. https://www.cnki.com.cn/Article/CJFDTOTAL-LCEH202204002.htm
[10] Gerth DJ, Tashiro J, Thaller SR. Pediatric sinonasal tumors in the United States: incidence and outcomes[J]. J Surg Res, 2014, 190(1): 214-220. doi: 10.1016/j.jss.2014.04.004
[11] Benoit MM, Bhattacharyya N, Faquin W, et al. Cancer of the nasal cavity in the pediatric population[J]. Pediatrics, 2008, 121(1): e141-145. doi: 10.1542/peds.2007-1319
[12] Shay SG, Valika T, Chun R, et al. Innovations in Endonasal Sinus Surgery in Children[J]. Otolaryngol Clin North Am, 2019, 52(5): 875-890. doi: 10.1016/j.otc.2019.06.003
[13] Albonette-Felicio T, Rangel GG, Martinéz-Pérez R, et al. Surgical management of anterior skull-base malignancies(endoscopic vs. craniofacial resection)[J]. J Neurooncol, 2020, 150(3): 429-436. doi: 10.1007/s11060-020-03413-y
[14] Podboj J, Smid L. Endoscopic surgery with curative intent for malignant tumors of the nose and paranasal sinuses[J]. Eur J Surg Oncol, 2007, 33(9): 1081-1086. doi: 10.1016/j.ejso.2007.01.016
[15] 侯东明, 曹荣萍, 孟国珍, 等. 儿童鼻腔鼻窦肿瘤在内镜辅助下的诊断及手术治疗[J]. 山东大学耳鼻喉眼学报, 2008, 22(6): 515-516. https://www.cnki.com.cn/Article/CJFDTOTAL-SDYU200806017.htm