Duan Hong-Gang, Zheng Chun-Quan, Wang De-Hui, Ding Guo-Qiang, Luo Ji-Qin, Zang Chao-Ping, Yu Chang
Department of Otolaryngology, Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China.
Eur Arch Otorhinolaryngol. 2015 Sep;272(9):2313-8. doi: 10.1007/s00405-014-3297-7. Epub 2014 Oct 16.
Sinonasal Rosai-Dorfman disease (S-RDD) is a rare form of RDD limited to the sinonasal cavity. Multipatient studies of Chinese S-RDD and documentation of its clinical spectrum are rare. This study aimed to identify the clinical profiles of Chinese S-RDD. Medical records of and tissue sections from 10 patients diagnosed with S-RDD between 2007 and 2014 were reviewed. Data on clinical presentations, endoscopy signs, imageological change, treatment and outcome were analyzed. The mean age of five male and five female patients at the first visit was 40.3 years and the mean follow-up period was 58.6 months. Based on the lesion sites, five cases were divided into an anterior sinonasal group, accompanied by symptoms of epistaxis, nasal obstruction and nasal dorsal deformity. Five other cases were divided into a posterior sinonasal group, accompanied by symptoms of hyposmia, epistaxis and nasal obstruction. Endoscopy signs and imageological changes in the anterior group showed diffuse infiltration of the RDD lesion under the septum mucosa, but in the posterior group the RDD lesions often showed as formations on polyps. At the end of follow-up, only one case spontaneously resolved without surgery; two cases in the anterior sinonasal group and three cases in the posterior sinonasal group recurred after endoscopic surgery, but surgery can result in short-term symptomatic control and restoration of function in all cases. S-RDD of the anterior and posterior sinonasal cavity may have different clinical characteristics; endoscopic surgery is effective for short-term symptomatic control and restoration of function for S-RDD.
鼻窦罗萨伊-多夫曼病(S-RDD)是罗萨伊-多夫曼病的一种罕见形式,局限于鼻窦腔。关于中国S-RDD的多患者研究及其临床谱记录很少。本研究旨在确定中国S-RDD的临床特征。回顾了2007年至2014年间确诊为S-RDD的10例患者的病历和组织切片。分析了临床表现、内镜检查体征、影像学变化、治疗及转归的数据。5例男性和5例女性患者首次就诊时的平均年龄为40.3岁,平均随访期为58.6个月。根据病变部位,5例分为鼻窦前组,伴有鼻出血、鼻塞和鼻背畸形症状。另外5例分为鼻窦后组,伴有嗅觉减退、鼻出血和鼻塞症状。前组的内镜检查体征和影像学变化显示鼻中隔黏膜下RDD病变弥漫性浸润,而后组的RDD病变常表现为息肉样肿物。随访结束时,仅1例未经手术自行缓解;鼻窦前组2例和鼻窦后组3例在内镜手术后复发,但手术可使所有病例获得短期症状控制和功能恢复。鼻窦前、后腔的S-RDD可能具有不同的临床特征;内镜手术对S-RDD的短期症状控制和功能恢复有效。