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一例鼻窦嗜酸性粒细胞性血管中心性纤维化病例报告及系统综述

A Case Report and Systematic Review of Eosinophilic Angiocentric Fibrosis of the Paranasal Sinuses.

作者信息

Heft Neal Molly E, Rowan Nicholas R, Willson Thomas J, Wang Eric W, Lee Stella E

机构信息

1 University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.

2 University of Michigan Department of Otolaryngology, Ann Arbor, Michigan, USA.

出版信息

Ann Otol Rhinol Laryngol. 2017 May;126(5):415-423. doi: 10.1177/0003489417696510. Epub 2017 Mar 1.

Abstract

OBJECTIVE

There is a paucity of literature discussing prognostic factors or comparing outcomes in eosinophilic angiocentric fibrosis (EAF). This review aims to analyze tumor and patient characteristics as possible prognostic markers and compare surgical approaches.

METHODS

Systematic literature review and case report analyzing available cases of EAF located within the paranasal sinuses.

RESULTS

The literature search yielded 39 articles meeting criteria for a total of 59 cases (including 1 from our institution). Median patient age was 46 years. The most common presenting symptoms were nasal obstruction (69%, n = 41) and change in external nasal appearance (39%, n = 32). The majority of cases (85%) were treated with surgical resection alone or in combination with medication. Of surgical patients, 62% underwent a complete resection with a recurrence rate of 20%. Median follow-up duration was 2 years. Endoscopic approach showed a significant positive correlation with complete resection ( P = .045). Patient sex ( P = .6), tumor location (range, P = .32-.98), lateral rhinotomy ( P = .26), septoplasty ( P = .84), and external rhinoplasty ( P = .28) were not significantly correlated with total resection. Insufficient sample size precluded calculation of predictors of recurrence following surgery.

CONCLUSION

This review suggests that an endoscopic approach to EAF tumor is a viable option, frequently yielding complete resection.

摘要

目的

关于嗜酸性粒细胞性血管中心性纤维化(EAF)预后因素的讨论或结局比较的文献较少。本综述旨在分析肿瘤和患者特征作为可能的预后标志物,并比较手术方法。

方法

对位于鼻窦内的EAF现有病例进行系统文献综述和病例报告分析。

结果

文献检索得到39篇符合标准的文章,共59例病例(包括我们机构的1例)。患者中位年龄为46岁。最常见的症状是鼻塞(69%,n = 41)和鼻外观改变(39%,n = 32)。大多数病例(85%)仅接受手术切除或联合药物治疗。在接受手术的患者中,62%进行了完整切除,复发率为20%。中位随访时间为2年。内镜手术与完整切除呈显著正相关(P = .045)。患者性别(P = .6)、肿瘤位置(范围,P = .32 - .98)、鼻侧切开术(P = .26)、鼻中隔成形术(P = .84)和鼻外成形术(P = .28)与完全切除无显著相关性。样本量不足,无法计算手术后复发的预测因素。

结论

本综述表明,EAF肿瘤的内镜手术是一种可行的选择,通常能实现完整切除。

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