Yang X J, Tang L X, Wang P P, Zhang N, Sun J H, Zhang W, Ge W T
Department of Otorhinolaryngology Head and Neck Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China.
Department of Pathology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China.
Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2021 Feb 3;56(2):117-123. doi: 10.3760/cma.j.cn115330-20200722-00614.
To summarize clinical features and our experience of the diagnosis and treatment of pediatric nasal neuroglial heterotopia (NGH). Clinical data of 13 nasal NGH patients in Beijing Children's Hospital from August 2014 to October 2019 were retrospectively reviewed, including 9 boys and 4 girls, aged from 1 to 38 months with median age of 5 months. Radiological workups and excision of nasal NGH under general anesthesia were performed for all patients. B ultra-sound and MRI were performed for all external and mixed lesions, while ultra-low-dose CT scan and MRI for all intranasal type. Surgical approaches were dependent on location and extent of the lesions according to radiographic workup, including extranasal or transnasal endoscopic approach. Patients were followed up regularly after operation to evaluate the effect. Initial presentation, locations, imaging findings, surgical approaches and follow-up results were analyzed through descriptive statistical method. Eight nasal NGH patients presented with an internal nasal mass and nasal obstruction, which belonged to intranasal type. Three patients presented with an external nasal mass which belonged to extranasal type and 2 patients had mixed lesions. The sites included nasal dorsum (=5), anterior to the middle turbinate (=5) and olfactory cleft (=3). Surgical resections were done through median rhinotomy approach (=5) or transnasal endoscopic approach (=8). All the operations were successful and no complication occurred. All cases were followed up from 3 to 65 months. No recurrence was encountered. Nasal NGH is a rare lesion with atypical clinical presentation. Preoperative imaging including CT scan and MRI is essential for evaluation of the location, extent of the disease and for making the surgical plan. Treatment requires complete surgical excision.
总结小儿鼻腔神经胶质异位（NGH）的临床特征以及我们在其诊断和治疗方面的经验。回顾性分析2014年8月至2019年10月在北京儿童医院就诊的13例鼻腔NGH患者的临床资料，其中男9例，女4例，年龄1至38个月，中位年龄5个月。所有患者均接受了鼻腔NGH的放射学检查及全身麻醉下的切除术。所有外部及混合性病变均行B超和MRI检查，所有鼻内型病变均行超低剂量CT扫描和MRI检查。根据影像学检查结果，手术入路取决于病变的位置和范围，包括鼻外入路或经鼻内镜入路。术后定期随访评估疗效。采用描述性统计方法分析初始表现、病变部位、影像学表现、手术入路及随访结果。8例鼻腔NGH患者表现为鼻内肿物及鼻塞，属于鼻内型。3例患者表现为鼻外肿物，属于鼻外型，2例患者为混合性病变。病变部位包括鼻背（5例）、中鼻甲前方（5例）和嗅裂（3例）。手术切除通过正中鼻切开入路（5例）或经鼻内镜入路（8例）进行。所有手术均成功，无并发症发生。所有病例随访3至65个月，无复发。鼻腔NGH是一种罕见病变，临床表现不典型。术前影像学检查（包括CT扫描和MRI）对于评估病变的位置、范围及制定手术方案至关重要。治疗需要完整的手术切除。
