Florin Whitney, Mandel Louis
Oral and Maxillofacial Surgery Resident, New York-Presbyterian Hospital, Columbia Campus, New York, NY, USA.
J Oral Maxillofac Surg. 2012 Oct;70(10):2352-5. doi: 10.1016/j.joms.2011.11.008. Epub 2012 Jan 24.
We present a patient who developed a delayed granulomatous reaction after injections of hyaluronic acid and bovine collagen glutaraldehyde that were introduced 6 and 4 years, respectively, previous to her present visit. She was a healthy 65-year-old woman, who was seen in November 2010 at the Columbia University Salivary Gland Center with a tentative diagnosis of a left buccal facial swelling caused by a "blocked parotid duct." The swelling was only slightly painful and had developed 1 month previously after a periodontal surgical procedure that involved the maxillary left quadrant. Questioning indicated that the swelling did not fluctuate in size nor had it changed its configuration since its sudden inception 2 days after the periodontal surgery. Visibly, the swelling was slightly erythematous. Palpation caused only mild discomfort and revealed the swelling to be quite firm in tone. The lesion involved the left facial buccal tissues, with its extraoral center corresponding to the intraoral location of the parotid duct orifice. The swelling was diffuse, with no definitive outline. It measured approximately 3 cm horizontally and 3.5 cm in height. Posteriorly, palpation of the left parotid gland revealed the gland to be painless, normal in tone, and not swollen. No swelling or discomfort was evident on the right side. No trismus was present.
我们报告一位患者，她在分别于此次就诊前6年和4年注射透明质酸和戊二醛交联牛胶原蛋白后出现了迟发性肉芽肿反应。她是一位65岁的健康女性，2010年11月在哥伦比亚大学唾液腺中心就诊，初步诊断为因“腮腺导管阻塞”导致的左侧颊面部肿胀。肿胀仅有轻微疼痛，在涉及左上颌象限的牙周手术后1个月出现。询问得知，自牙周手术后2天突然出现肿胀以来，其大小未波动，形态也未改变。肉眼可见，肿胀处有轻微红斑。触诊仅引起轻度不适，发现肿胀质地相当硬。病变累及左侧颊面部组织，其口外中心对应腮腺导管口的口内位置。肿胀呈弥漫性，无明确边界。水平方向约3 cm，高约3.5 cm。在后方，触诊左侧腮腺发现腺体无痛，质地正常，未肿胀。右侧未发现肿胀或不适。无牙关紧闭。
