Lenci Lucas T, Shams Pari, Shriver Erin M, Allen Richard C
Department of Ophthalmology and Visual Sciences, University of Iowa Hospitals and Clinics, Iowa City, Iowa.
Moorfields Eye Hospital, London, United Kingdom.
J AAPOS. 2017 Feb;21(1):44-47. doi: 10.1016/j.jaapos.2016.09.023. Epub 2017 Jan 9.
To evaluate the clinical characteristics and role of imaging in the evaluation of dermoid cysts and to determine predictors of cyst rupture during surgical excision of dermoid cysts.
In this single-center, consecutive, nonrandomized comparative case series, the records of consecutive patients with suspected dermoid cysts who underwent surgery between January 1, 2000, and December 31, 2014, were reviewed retrospectively for demographic information, clinical findings, preoperative imaging, surgical details, and pathology reports.
A total of 100 patients were included. Cyst volume was similar between superomedial and superotemporal lesions (P = 0.61) but greater in patients >10 years of age (P < 0.001). Immobility of the cyst was present in all complex dermoids (4/4), but there was no difference in the mobility of superotemporal or superomedial cysts (P = 0.69). Forty-two patients underwent imaging; superomedial lesions were more likely to be imaged than superotemporal lesions (P = 0.073). All 4 patients with complex dermoids presented with orbital signs and underwent preoperative imaging. None of the remaining 38 patients who underwent imaging had orbital signs, and the results of imaging had no effect on surgical planning. Intraoperative cyst rupture occurred in 18 patients. There was no significant difference in cyst rupture between superotemporal and superomedial cysts (P = 0.452). Smaller cyst volume was associated more often with intraoperative cyst rupture (P < 0.001).
Preoperative imaging of superomedial and superolateral dermoid cysts is likely unnecessary unless associated with orbital signs. Intraoperative cyst rupture is not influenced by cyst location but does appear to be more likely in smaller cysts.
评估皮样囊肿的临床特征及影像学检查在其评估中的作用，并确定皮样囊肿手术切除过程中囊肿破裂的预测因素。
在这个单中心、连续、非随机的比较病例系列研究中，回顾性分析了2000年1月1日至2014年12月31日期间连续接受手术的疑似皮样囊肿患者的记录，以获取人口统计学信息、临床发现、术前影像学检查、手术细节和病理报告。
共纳入100例患者。颞上和颞内侧病变的囊肿体积相似（P = 0.61），但10岁以上患者的囊肿体积更大（P < 0.001）。所有复杂皮样囊肿（4/4）的囊肿均固定不动，但颞上或颞内侧囊肿的活动度无差异（P = 0.69）。42例患者接受了影像学检查；颞内侧病变比颞上病变更有可能接受影像学检查（P = 0.073）。所有4例复杂皮样囊肿患者均出现眼眶体征并接受了术前影像学检查。其余38例接受影像学检查的患者均无眼眶体征，且影像学检查结果对手术规划无影响。18例患者术中发生囊肿破裂。颞上和颞内侧囊肿之间的囊肿破裂无显著差异（P = 0.452）。较小的囊肿体积更常与术中囊肿破裂相关（P < 0.001）。
除非伴有眼眶体征，颞内侧和颞外侧皮样囊肿术前影像学检查可能不必要。术中囊肿破裂不受囊肿位置影响，但较小的囊肿似乎更易发生。
