Department of Otolaryngology Head and Neck Surgery, Northwestern Medical Faculty Foundation, Chicago, Illinois 60611, USA.
Am J Rhinol Allergy. 2013 Mar-Apr;27(2):128-33. doi: 10.2500/ajra.2013.27.3840.
BACKGROUND: This study was designed to investigate the clinical features and the growth rate of craniofacial osteomas. METHODS: Retrospective chart review was performed of 200 cases of craniofacial osteomas diagnosed from January 2001 to September 2011. Data pertinent to patient and osteoma lesion characteristics were collected. Histology of operated cases was reviewed. Computer tomography (CT) charts were reviewed and those with multiple images were analyzed for growth characteristics. RESULTS: One hundred forty-nine patients met our inclusion criteria. Eighty-nine percent of these osteomas were found incidentally. Forty-three percent were in the frontal sinus. Fifteen percent of the patients complained of headaches and only 6.71% of patients with osteoma had headaches congruent with osteoma location. Thirty-one percent of CT scans had sinus mucosal disease; only 8% had mucosal disease adjacent to the osteoma. Ten of the 149 patients underwent surgery for cosmetic and/or rapidly growing osteomas. Thirteen patients had intestinal tubular adenoma, and one was genetically positive for Gardner's syndrome. Fifty-two patients had multiple CT scans that were included in growth rate analysis. The mean linear growth rate of osteomas was estimated to be 0.117 mm/yr (95% CI, 0.004, 0.230) in maximal dimension, assuming linear growth. A descriptive analysis of osteoma growth divided the osteomas into several intervals and studied the growth rate separately in each interval. The median change in maximum dimension was different in each interval in a nonsystematic manner, ranging from -0.066 mm, over 3- to 9-month interval (interquartile range [IQR] = -0.404-1.069), to 0.369 mm over 9- to 15-month interval (IQR = -0.032-0.855), and 0.082 mm over 45- to 51-month interval (IQR = -0.000-0.197). There was no significant association between tumor size, location, or complications. CONCLUSION: Craniofacial osteomas are slow-growing lesions with no specific growth pattern and rare complications. Their clinical behavior is ill defined and justifies a conservative approach toward asymptomatic lesions with close radiological follow-up.
背景：本研究旨在探讨颅面骨骨瘤的临床特征和生长速度。
方法：对 2001 年 1 月至 2011 年 9 月期间诊断的 200 例颅面骨骨瘤患者进行回顾性病历分析。收集患者和骨瘤病变特征的相关数据。对手术病例的组织学进行回顾。对有多个图像的 CT 图表进行分析，以研究生长特征。
结果：149 名患者符合我们的纳入标准。这些骨瘤中 89%是偶然发现的。43%位于额窦。15%的患者有头痛，只有 6.71%的骨瘤患者头痛与骨瘤位置相符。31%的 CT 扫描显示窦黏膜疾病；只有 8%的骨瘤旁有黏膜疾病。149 名患者中有 10 名因美容和/或生长迅速的骨瘤而行手术治疗。13 名患者患有肠管状腺瘤，1 名患者患有 Gardner 综合征的遗传阳性。52 名患者有多个 CT 扫描，包括生长率分析。假设线性生长，骨瘤最大尺寸的平均线性生长率估计为 0.117mm/yr（95%CI，0.004，0.230）。对骨瘤生长进行描述性分析，将骨瘤分为几个间隔，并分别研究每个间隔的生长率。在每个间隔中，最大尺寸的中位数变化是非系统性的，范围从-0.066mm，3-9 个月间隔（四分位距[IQR]=-0.404-1.069），到 0.369mm，9-15 个月间隔（IQR=-0.032-0.855），和 0.082mm，45-51 个月间隔（IQR=-0.000-0.197）。肿瘤大小、位置或并发症之间无显著相关性。
结论：颅面骨骨瘤生长缓慢，无特定生长模式，并发症罕见。它们的临床行为定义不明确， justifies 对无症状病变采取保守治疗，密切影像学随访。
Am J Rhinol Allergy. 2013
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