摘要
目的:骨瘤、骨化纤维瘤(OF)、骨纤维异常增生症(FD)三种鼻窦及颌面部良性纤维骨性病变(FOLS)的分析比较。方法:回顾分析2012-2017年间来我科就诊的共273例鼻窦及颌面部FOLS患者(骨瘤153例,OF 44例,FD 76例)的病例资料,并对患者进行6个月~5年的随访,分析比较三种病变在发病率、性别、年龄、病变部位、术前血清ALP的含量及复发率的差异。结果:骨瘤多发于鼻窦(72.5%),其中筛窦(50.3%)最常见,额窦(22.1%)次之,17.7%的骨瘤患者合并鼻窦炎,女性发病率约为男性患者的2倍,未见术后复发病例。OF多发于颌面骨(65.9%),以单骨型病变(75.0%)为主,其中发于鼻窦(34.1%)者以筛窦(27.3%)多见,27.3%的患者合并鼻窦炎;男女发病率未见明显差异;复发率为13.6%。FD多发于颌面骨(64.5%),多为单骨型病变(64.5%),其中以上颌骨(50.0%)最为常见;病变位于鼻窦者多为多骨型病变,其中以蝶窦(34.2%)最为多见,FD男女发病率未见明显差异;13.2%的患者合并鼻窦炎,术后复发率为14.5%,其中9例(75.0%)患者首次手术年龄小于20岁。骨瘤、OF、FD的平均发病年龄分别为(40.7±14.55)岁、(28.0±17.9)岁和(20.32±15.2)岁,差异有统计学意义(P<0.01);3种病变患者术前血清ALP含量分别为(68.3±24.1)U/L、(130.1±107.0)U/L和(127.7±78.7)U/L,差异有统计学意义(P<0.01)。OF单骨型与多骨型病变患者术前血清ALP分别为(117.2±92.6)U/L和(168.7±140.1)U/L,差异无统计学意义(P>0.01);FD单骨型与多骨型病变患者术前血清ALP分别为(122.2±82.9)U/L和(137.7±70.7)U/L,差异无统计学意义(P>0.01)。结论:骨瘤、OF、FD三种鼻窦及颌面部良性纤维骨性病变的发病年龄、病变部位、术前血清ALP含量及复发率存在差异。手术治疗是目前最有效的治疗方法。
Objective：To compare and analyze the incidence,clinical features,imaging features,the preoperative serum alkalinosis phosphatase（ALP）and recurrence rates of osteoma,ossifying fibroma（OF）,and fibrous dysplasia（FD）in sinus and maxillofacial benign fibrosis（FOLS）.Method：The 273 cases of FOLS with paranasal sinus and maxillofacial region in our hospital,among which there were 153 cases of osteoma,44 cases of OF,and76 cases of FD,were reviewed retrospectively and were follow-up for 6 months to 5 years.The incidence,gender,age,lesion location,preoperative serum ALP levels and recurrence rate of different lesions were analyzed and compared.Result：Most Osteoma occurred in paranasal sinus（72.5%）,among which the most common part was ethmoid sinus（50.3%）and followed by the frontal sinus（22.1%）,the ratio of female to male was 2：1,and there were 27 cases（17.7%）accompanied by sinusitis.None of the patients relapsed.Most OF occurred in the maxillofacial bone（65.9%）and most of the lesions were monostotic（75.0%）.For those occurred in the paranasal sinuses,the ethmoid sinus（27.3%）were the most common part than others.The ratio of femal to male was almost1∶1 and there were 12 cases（27.3%）accompanied by sinusitis.The recurrence rate of the OF was 13.6%.Most FD occured in maxillofacial bone（64.5%）were the monostotic form（64.5%）,and in which the most common part was the maxilla（50.0%）.While,most of those occurred in the paranasal sinuses were the polyostotic ones,and sphenoid sinus（34.2%）were the most common parts.The ratio of femal to male was almost 1∶1 and there were 10 cases（13.2%）accompanied by sinusitis.12 cases relapsed（14.5%）,and there were 9 cases（75.0%）acceptted the first surgery before the age of 20.The average age of onset among Osteoma[（40.7±14.55）y],OF[（28.0±17.9）y]and FD[（20.32±15.2）y]were significant different（P〈0.01）.The preoperative serum ALP content among Osteoma[（68.3±24.1）U/L,OF（130.1±107.0）U/L an
作者
汪月
董栋
赵玉林
WANG Yue;DONG Dong;ZHAO Yulin(Department of Rhinology,the First Affiliated Hospital of Zhengzhou University,Zhengzhou,450052,China)
出处
《临床耳鼻咽喉头颈外科杂志》
CAS
北大核心
2018年第15期1188-1191,共4页
Journal of Clinical Otorhinolaryngology Head And Neck Surgery
关键词
鼻窦
颌面部
良性纤维骨性病变
骨瘤
骨化纤维瘤
骨纤维异常增生症
paranasal sinuses
maxillofacial region
benign fibrous ossification
osteoma
ossifying fibroma
fibrous dysplasia of bone
