Kim Seon-Yeong, Alfafara Angenine, Kim Jin-Woo, Kim Sun-Jong
Graduate Student, Researcher, Graduate School of Clinical Dentistry and the Department of Oral and Maxillofacial Surgery, Ewha Womans University, Seoul, Korea.
Assistant Professor, Graduate School of Clinical Dentistry and the Department of Oral and Maxillofacial Surgery, Ewha Womans University, Seoul, Korea.
J Oral Maxillofac Surg. 2017 Sep;75(9):1926-1931. doi: 10.1016/j.joms.2017.05.019. Epub 2017 May 30.
Traumatic herniation of a buccal fat pad, predominantly seen in young children, is a rare condition. Because of its rarity and clinical features that resemble tumors, clinicians are faced with challenges at the initial diagnosis. This report describes a case of buccal fat pad herniation with excellent long-term prognosis after surgical relocation and conservative treatment and presents a systematic review of the literature on its management.
Through a PubMed search, 811 articles were initially identified. Case series, case reports, technical notes, case and review reports, and retrospective case series were included. After screening and manual review, the sample was narrowed to 35 reports (41 patients) based on eligibility criteria. Articles were included if the standard criteria for traumatic intraoral herniation of buccal fat pad were met.
Patients' ages ranged from 4 months to 12 years, with no specific gender predilection. Management consisted of excision (82.9%), relocation (14.6%), and observation (2.4%). Follow-up ranged from 1 week to 4 months. No reports presented a follow-up longer than 4 months; hence, data on long-term prognosis were not reported. For the present case report, a 19-month-old boy diagnosed with traumatic buccal fat pad herniation was successfully treated with surgical relocation and antibiotic support. Twelve-month follow-up showed no esthetic or functional disturbance or recurrence.
Traumatic herniation of the buccal fat pad requires special attention at the initial diagnosis. Considering its clinical importance in young children and few studies have reported long-term postresection follow-up, surgical relocation can be regarded as an excellent and more conservative treatment option.
颊脂垫外伤性疝出主要见于幼儿，是一种罕见病症。由于其罕见性以及临床特征类似肿瘤，临床医生在初始诊断时面临挑战。本报告描述了一例经手术复位和保守治疗后长期预后良好的颊脂垫疝出病例，并对其治疗的相关文献进行了系统综述。
通过PubMed检索，初步识别出811篇文章。纳入病例系列、病例报告、技术笔记、病例与综述报告以及回顾性病例系列。经过筛选和人工审核，根据纳入标准将样本缩小至35篇报告（41例患者）。若符合颊脂垫外伤性口腔内疝出的标准则纳入文章。
患者年龄从4个月至12岁不等，无特定性别倾向。治疗方式包括切除（82.9%）、复位（14.6%）和观察（2.4%）。随访时间从1周至4个月。无报告随访时间超过4个月；因此，未报告长期预后数据。对于本病例报告，一名19个月大被诊断为外伤性颊脂垫疝出的男孩经手术复位和抗生素支持治疗成功。12个月的随访显示无美学或功能障碍或复发。
颊脂垫外伤性疝出在初始诊断时需要特别关注。鉴于其在幼儿中的临床重要性且很少有研究报告切除后的长期随访情况，手术复位可被视为一种良好且更保守的治疗选择。
