Karkas A, Righini C, Reyt E
Service d'otorhinolaryngologie et de chirurgie cervicofaciale, centre hospitalier universitaire de Grenoble, BP 217, 38043 Grenoble cedex 09, France.
Ann Otolaryngol Chir Cervicofac. 2007 Nov;124(5):239-43. doi: 10.1016/j.aorl.2007.03.008. Epub 2007 Sep 11.
In daily practice, the otorhinolaryngologist may face cases of facial tumors of sinonasal origin. Their diagnosis remains difficult based on clinical findings alone. Therefore, imaging techniques can guide the surgeon toward the correct diagnosis.
A 14-year-old male presented with a history of headaches and nasal obstruction. Physical examination revealed a mass in the right nasal fossa.
A computed tomography scan showed an isodense lesion in the posterior half of the right nasal fossa, extending into the maxillary sinus, orbital floor, pterygopalatine fossa, and infratemporal fossa. Magnetic resonance imaging showed great enhancement upon gadolinium administration. The diagnosis of schwannoma was suggested after angiography was performed. The tumor was then resected via a transfacial approach with maxillozygomatic osteotomy. Pathologic examination confirmed the diagnosis of schwannoma.
The definite diagnosis of a sinonasal tumor can be confirmed only histologically. However, preoperative radiological data can direct the surgeon toward the correct diagnosis and above all the most appropriate surgical approach.
在日常临床实践中,耳鼻喉科医生可能会遇到鼻窦源性面部肿瘤病例。仅根据临床检查结果进行诊断仍然困难。因此,成像技术可为外科医生提供正确诊断的指导。
一名14岁男性,有头痛和鼻塞病史。体格检查发现右侧鼻腔有肿物。
计算机断层扫描显示右侧鼻腔后半部等密度病变,延伸至上颌窦、眶底、翼腭窝和颞下窝。磁共振成像显示钆剂注射后有明显强化。血管造影后提示为神经鞘瘤。随后通过经面部上颌骨颧突截骨术切除肿瘤。病理检查确诊为神经鞘瘤。
鼻窦肿瘤的明确诊断只能通过组织学检查来确定。然而,术前影像学资料可以指导外科医生做出正确诊断,尤其是选择最合适的手术方式。