de Chalain Tristan, Tan Beryl
Regional Center for Plastic Surgery, Middlemore Hospital, Otahuhu, Auckland, New Zealand.
J Craniofac Surg. 2003 Sep;14(5):729-35. doi: 10.1097/00001665-200309000-00024.
The authors describe the clinical presentation, investigation, and surgical management of two cases of benign ivory osteoma of the craniofacial skeleton. In the first case, a bony mass located over the frontal region had become a cosmetic burden to the patient, and she requested removal with minimal morbidity. Accordingly, an endoscopic procedure, with minimal access incisions located behind the hairline, was devised. In the second case, the patient, a Jehovah's Witness, presented with a long history of slowly enlarging bony masses over the maxilla and in the pterygopalatine space. She finally requested surgical intervention when the symptoms of pain related to fifth nerve compression at the foramen ovale became intolerable. Key aspects of the preoperative and perioperative management strategies used to avoid blood transfusion are detailed, as is the surgical approach, which included a bicoronal scalp flap with temporary removal of the zygomatic arch and the coronoid process. Finally, the etiology, histology, and natural history of ivory osteomas are discussed.
作者描述了两例颅面骨骼良性骨瘤的临床表现、检查及手术治疗情况。第一例中，位于额部的骨块给患者带来了外观困扰，她要求在尽可能减少并发症的情况下将其切除。因此，设计了一种内镜手术，在发际线后方做最小切口。第二例患者是一名耶和华见证会成员，上颌及翼腭窝处有缓慢增大的骨块病史已久。当卵圆孔处因第五神经受压引起的疼痛症状变得难以忍受时，她最终要求手术干预。文中详细介绍了为避免输血所采用的术前及围手术期管理策略的关键要点，以及手术入路，包括双冠状头皮瓣并临时切除颧弓和冠突。最后，讨论了骨瘤的病因、组织学及自然病程。
