鼻腔鼻窦异位脑膜瘤的诊治(附9例报道)

目的 探讨提高鼻腔鼻窦异位脑膜瘤临床诊治水平的方法。方法 回顾性分析9例鼻腔鼻窦异位脑膜瘤的临床资料，总结诊疗经验。结果 9例患者全部为沙粒体型脑膜瘤，临床症状无特异性，因病史长短不同而表现各异。所有病例均行手术治疗，其中2例复发，再次手术而愈。结论 鼻腔鼻窦异位脑膜瘤的治疗以手术为主，而鼻内镜手术可作为治疗该类肿瘤的重要方式。     

鼻腔鼻窦异位脑膜瘤的诊断和外科治疗

目的探讨鼻腔鼻窦异位脑膜瘤的临床特点、诊断及治疗.方法回顾分析鼻腔鼻窦异位脑膜瘤5例的临床资料.结果5例中,原发性1例,经鼻侧切开切除肿瘤,5个月后肿瘤复发,带瘤生存;继发性4例经额颞大冠状切口入路手术3例次,颅面联合进路,上唇中隔蝶窦径路,鼻侧切开、枕颈部入路各1次.术后随访1年或1年以上,无复发2例,死亡1例,失去联系1例.结论手术是治疗鼻腔鼻窦异位脑膜瘤的有效方法.切除不净是肿瘤复发的重要因素.确诊必须依靠病理组织学及免疫组化.     

延边地区113例鼻腔鼻窦恶性肿瘤的临床病理分析

目的 探讨延边地区鼻腔鼻窦恶性肿瘤的临床病理特征,为防治本地区鼻腔鼻窦恶性肿瘤提供科学依据.方法 回顾性分析我院1980-2007年经病理确诊的鼻腔鼻窦恶性肿瘤113例患者的临床病理资料.结果 本组113例中鳞癌占44.2%、淋巴瘤为28.3%和涎腺型癌占14.2%;朝、汉族中鳞癌各为38.3%和50.9%、恶性淋巴瘤为30.0%和26.4%、涎腺型癌为15.0%和13.2%;朝、汉族男性鳞癌发病平均年龄各为51.9和55.2岁、淋巴瘤为46.5和55.0岁(T=2.436,P<0.05);朝鲜族女性中鳞癌较多,汉族女性中恶性淋巴瘤较多.结论 延边地区鼻腔鼻窦恶性肿瘤中鳞癌最多,其次是恶性淋巴瘤和涎腺型癌,两个民族、不同性别中肿瘤的类型和平均年龄有差异,朝鲜族男性恶性淋巴瘤发病平均年龄比汉族男性明显年轻.     

鼻腔鼻窦少见肿瘤10例临床病理分析

目的增加对鼻腔鼻窦少见肿瘤的认识,为临床积累资料。方法回顾分析10例鼻腔鼻窦少见肿瘤的临床资料,其中良、恶性肿瘤各5例。结果 3例经2次以上活检确诊,2例曾误诊为鼻息肉,3例行2次以上手术,1例多形性腺瘤多次手术复发后恶变,术后2-3年无复发7例,6-10个月复发3例。结论鼻腔鼻窦少见肿瘤的临床表现无特异性,易被误诊,确诊需依靠病理检查或特殊的病理检查,活检应多点深取,疑多形性腺瘤者避免反复刺激,宜完整切除后送病检。预后与肿瘤的病理性质、生物学行为及手术切除范围等有关,足够大的手术范围是减少复发的关键。     

原发性鼻腔-鼻窦砂粒体型脑膜瘤1例报道并文献复习

目的 通过报道1例原发于鼻腔-鼻窦砂粒体型脑膜瘤患者的临床资料及相关文献复习,以提高临床医师对该病的认识及诊疗水平.方法 患者,女,50岁,因"渐进性右侧鼻塞1年余"入院.术前影像学检查提示右侧鼻腔及筛窦内不规则占位性病变,遂在全麻鼻内镜下行右侧鼻腔筛窦肿物切除术.结果 肿物完全切除,术后病理及免疫组化确诊为砂粒体型脑...     

鼻腔鼻窦软骨肉瘤9例临床分析

目的：提高对发生于鼻腔鼻窦的软骨肉瘤的诊治水平。方法：回顾性分析9例鼻腔鼻窦软骨肉瘤患者的临床资料。结果：鼻腔鼻窦软骨肉瘤的临床病理特征复杂且差别较大，4例继发性鼻腔鼻窦软骨肉瘤患者比原发性患者病变广泛且接近颅底，预后较差，不规则的斑块状钙化点是本病典型的影像学特点。9例均是经行部分或全部肿块切除后病理确诊，病理学分级以I级多见。结论：结合既往史，临床表现和CT检查，尽早手术探查行部分或全部肿块切除术有助于早期诊断和提高疗效。     

鼻腔鼻窦造釉细胞瘤临床分析

目的　探讨鼻腔鼻窦造釉细胞瘤的临床病理特点及治疗方法。方法　回顾性分析6例经病理确诊的鼻腔鼻窦造釉细胞瘤患者的临床资料。结果　6例患者均行手术治疗,随访时间为15个月～10年,术后3例复发,其中2例复发1次,1例复发2次,所有患者随访至今无一例死亡。结论　鼻腔鼻窦造釉细胞瘤发病率低,症状无特异性,诊断主要依靠病理及免疫组织化学检测。CT及MRI检查有助于了解病变的范围和性质,治疗以手术切除为主,术后复发率较高,有恶变倾向,需长期随访。     

鼻腔鼻窦恶性淋巴瘤临床诊断分析

目的:探讨鼻腔鼻窦恶性淋巴瘤临床特点、影像学特征、病理类型、误诊原因及其早期的诊断方法。方法:对34例鼻腔鼻窦恶性淋巴瘤临床病理资料进行回顾性分析。结果:鼻腔鼻窦恶性淋巴瘤好发于中年男性,发病率占同期鼻部恶性肿瘤的21.7%(34/157),鼻腔发病率(76.5%)明显高于鼻窦(17.6%)。首发症状主要表现为鼻塞、鼻出血、脓涕及发热等;体征主要表现为鼻腔新生物、鼻腔黏膜充血、糜烂、坏死及面部肿胀等;CT主要表现为病变部位在鼻腔前部和前中部,密度较均匀,可伴有软组织肿胀,骨质破坏少而轻;鼻腔淋巴瘤以NK/T细胞淋巴瘤为主,占61.5%(16/26),鼻窦淋巴瘤以B细胞淋巴瘤为主,占83.3%(5/6)。该病误诊率为21.2%。结论:鼻腔鼻窦恶性淋巴无特异性临床特征,CT影像具有一定的特征性,综合临床症状和体征、影像及病理特点,可提高对该病的认识及诊断准确率。     

鼻腔及鼻窦乳头状瘤

1概况3组织学形态鼻腔及鼻窦乳头状瘤是鼻腔呼吸道黏膜发生的良性肿瘤,占所有鼻腔肿瘤的0.5%～5%;乳头状瘤的发生与HPV感染有关,原位杂交证实有HPV6/11型存在[1];临床表现:男性多于女性;临床主要症状是鼻堵及衄血;绝大多数原发于鼻腔顶部或侧壁,也可以发生于鼻窦,常为单侧发生,     

鼻腔鼻窦恶性黑色素瘤17例临床分析

目的探讨鼻腔鼻窦恶性黑色素瘤的诊断和治疗,提高本病的诊疗水平。方法回顾性分析1980年3月-2011年6月收治的17例鼻腔鼻窦恶性黑色素瘤的临床资料,分析其临床病理特点、诊断、治疗及预后。结果患者的主要症状为单侧鼻塞,涕中带血,头痛;病灶位于鼻腔外侧壁和鼻中隔。17例患者中1例放弃治疗,2例行单纯放疗,14例行手术治疗,3、5年生存率分别为36．4％和22．2％。患者死亡原因为局部复发和远处转移。结论鼻腔鼻窦恶性黑色素瘤恶性程度高,易复发和转移,预后差,临床上尽早确诊。广泛彻底手术切除肿瘤,并辅以放疗、化疗、免疫治疗等综合治疗,是提高本病生存率的关键。     

Extracranial sinonasal tract meningioma: a case report

Extracranial meningioma is an unusual tumor, mainly found in the head and neck area. Before surgical removal and histopathological examination, this diagnosis is rarely considered. We report a case of an extracranial meningioma located in the frontal sinuses of a 65-year-old-woman. Symptomatology included trouble of vision due to bilateral exophtalmos and mild headaches. Bilateral exophtalmos was secondary to the development of huge frontal mucoceles. These mucoceles grew slowly due to the frontal recesses blockage by the extracranial meningioma. External approach was performed with removal of the mucocele walls and of the extracranial meningioma itself. The frontal recesses were blocked with synthetic cement, and orbital roofs were reconstructed with a polydioxanon-sheet (PDS). Frontal sinuses were excluded and filled with bone bank grafts. A review of the literature on extracranial meningioma and a discussion about the surgical management of this case are proposed in this paper.     

2 353例鼻腔鼻窦肿瘤临床病理分析

目的:了解我科20年来鼻腔鼻窦肿瘤的发生特点及其临床病理特征。方法:用常规病理方法分析了活检或手术切除的2 353例鼻腔鼻窦良性肿瘤,恶性肿瘤的构成及其临床病理特点。结果:良性肿瘤20种,584例,占24.82%;恶性肿瘤25种,1 769例,占75.18%。最常见的良性肿瘤分别是内翻性乳头状瘤,血管瘤和骨瘤,分别占该组病变的43.32%,15.75%,12.33%;最常见的恶性肿瘤分别为鳞状细胞癌,恶性淋巴瘤和腺癌,分别占该组病变的66.67%、14.13%、5.94%。结论:发生于鼻腔鼻窦区的新生物,在临床病理学上具有多样性和复杂性的特点。     

Recurrent extracranial sinonasal meningioma presenting 27 years after complete surgical eradication of right frontal meningioma

A 79-year-old man presented to our department with nasal obstruction and postnasal drip. On examination he had unusual bilateral nasal polyps, which were histologically diagnosed as meningioma. Twenty-seven years earlier he had undergone successful removal of a right frontal meningioma. A CT scan performed 7 years after his primary surgery had shown complete excision with no evidence of recurrence. Extracranial meningiomas are rare tumours and are usually extensions from an intracranial mass lesion. We document what we believe to be the first case of an extracranial meningioma, presenting as nasal polyps, 27 years after successful surgical eradication of the primary lesion.     

Recurrent extracranial sinonasal meningioma presenting 27 years after complete surgical eradication of right frontal meningioma

A 79-year-old man presented to our department with nasal obstruction and postnasal drip. On examination he had unusual bilateral nasal polyps, which were histologically diagnosed as meningioma. Twenty-seven years earlier he had undergone successful removal of a right frontal meningioma. A CT scan performed 7 years after his primary surgery had shown complete excision with no evidence of recurrence. Extracranial meningiomas are rare tumours and are usually extensions from an intracranial mass lesion. We document what we believe to be the first case of an extracranial meningioma, presenting as nasal polyps, 27 years after successful surgical eradication of the primary lesion.     

Primary meningioma of the nasopharynx: case report and review of ectopic meningioma

Meningiomas not uncommonly spread outside the central nervous system, but primary extracranial meningiomas are much less common, the sites described including the orbit, the calvarium, the neck, the temporal bone and the paranasal sinuses. Reported here is the first instance of extracranial meningioma of the nasopharynx. The histological appearance of meningiomas is diverse, and in ectopic sites can be mistaken for malignant epithelial tumors, as happened here initially. The tumor was excised via a transpalatal flap using an intracapsular debulking approach borrowed from the armamentarium of the intracranial surgeon. Prolonged follow-up with interval CT scans are recommended in patients with apparent ectopic meningioma, in case undemonstrable intracranial disease later becomes manifest.     

鼻腔鼻窦肌上皮癌临床分析

目的 探讨鼻腔鼻窦肌上皮癌的临床病理特点、治疗方法 及疗效.方法 回顾性分析四川省人民医院和浙江大学医学院附属第一医院1990年1月～2008年12月经病理确诊的鼻腔鼻窦肌上皮癌7例患者的临床资料.结果 7例患者均行手术治疗,随访6个月～7年,6例术后复发.3例术后出现颈淋巴结转移,其中2例行颈淋巴结清扫术,1例无手术...     

Primary ectopic meningioma in the right ethmoid sinus: a case report

A 29-year-old female with primary ectopic meningioma in the right ethmoid sinus was reported. She was treated by a right lateral rhinotomy with total removal of the tumor and the subsequent clinical course was good. Contrast enhanced magnetic resonance image (MRI) was most informative to define the tumor and decide the surgical procedure, in which it was demonstrated as well circumscribed mass lesion with considerable homogeneous contrast enhancement.     

Regional analysis of sinonasal ciliary beat frequency

BACKGROUND: Mucociliary clearance, a primary host defense mechanism, depends on mucus production and its clearance by the coordinated beating of cilia lining the airways. Numerous investigations have analyzed ciliary activity in brushings from the inferior turbinate. To date, only one study has investigated whether there exists variation in ciliary beat frequency (CBF) within the sinonasal cavity. We analyzed CBF from the inferior turbinate, uncinate process, and sphenoethmoid recess in nonsinusitis patients to determine regional variability of ciliary activity within the sinonasal cavity. METHODS: Explants of sinonasal epithelium were analyzed at 37 degrees C. Beating cilia were visualized with differential interference contrast microscopy. Images were captured using a high-speed digital camera with a sampling rate of 250 frames per second. A one-dimensional tracking algorithm analyzed individual pixel grayscale values within each frame of the video. The differences in grayscale were plotted as a time-dependent waveform, and frequency was calculated as the inverse of the peak-to-peak distance. A minimum of three areas of beating cilia were analyzed per regional sample. Statistical analysis was performed with repeated-measures analysis of variance. RESULTS: Complete sampling of all three sites was accomplished in 10 patients. No difference in CBF within the sinonasal cavity was identified (p < 0.05). The mean CBF for all sites in all patients was 12.6 +/- 2.9 Hz, in agreement with published values. CONCLUSION: This study shows no regional differences in CBF within the sinonasal cavity, supporting previous work and validating analysis of inferior turbinate cilia.