Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota, U.S.A.
Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota, U.S.A.
Laryngoscope. 2021 Sep;131(9):E2525-E2533. doi: 10.1002/lary.29478. Epub 2021 Mar 1.
OBJECTIVE/HYPOTHESIS: Aneurysmal bone cysts (ABCs) are benign, lytic bone lesions, which rarely present in the paranasal sinuses. There is no published consensus on the appropriate diagnostic or treatment approach. Our objective was to elucidate the clinical behavior, treatment, and outcomes for patients with ABCs of the paranasal sinuses (psABCs).
Retrospective case series and system review of the literature.
A retrospective chart review was performed to identify patients evaluated at the authors' institution with psABC and consolidated with literature reports of psABC.
Eighty-nine patients met inclusion criteria. The most common presenting symptom was painless facial swelling (n = 35, 39%). The ethmoid sinuses were the most common site involved (n = 55, 62%). Surgical approach was reported in 74 cases including 20 endoscopic and 54 with an open or combined approach. Fifty-nine patients (71%) underwent gross total resection. Follow up data was reported for 67 patients. Fifteen patients (22%) were found to have recurrence or progression at follow up; 10/15 (66%) patients within the first 12 months, 14/15 (93%) within the first 24 months, and 1/15 (7%) greater than 24 months after treatment. Patients were more likely to have recurrence/progression if they presented with nasal discharge (P = .05), proptosis (P = .01), or orbital involvement (P = .03).
psABCs typically present with painless swelling or nasal obstruction. Orbital involvement is a negative prognostic indicator with these patients more likely to have recurrence after treatment. Recurrence or progression of disease is most likely to occur within 2 years after treatment. Therefore, patients should be monitored closely during this time.
4 Laryngoscope, 131:E2525-E2533, 2021.
目的/假设：动脉瘤样骨囊肿（ABC）是一种良性的、溶骨性骨病变，很少发生在鼻窦。目前尚无关于其适当诊断或治疗方法的共识。我们的目的是阐明发生在鼻窦（psABC）的 ABC 的临床行为、治疗和结局。
回顾性病例系列和文献系统综述。
对作者所在机构评估的患有 psABC 的患者进行回顾性图表审查，并与文献报道的 psABC 病例进行整合。
符合纳入标准的患者共 89 例。最常见的首发症状是无痛性面部肿胀（n=35，39%）。额窦是最常见的受累部位（n=55，62%）。报告了 74 例手术方式，包括 20 例内镜手术和 54 例开放性或联合手术。59 例（71%）患者行大体全切除。报道了 67 例患者的随访数据。15 例（22%）患者在随访时发现复发或进展；15 例中 10 例（66%）在治疗后 12 个月内，14 例（93%）在 24 个月内，1 例（7%）在 24 个月后。如果患者出现鼻腔分泌物（P=.05）、眼球突出（P=.01）或眶内受累（P=.03），则更有可能出现复发/进展。
psABC 通常表现为无痛性肿胀或鼻塞。眶内受累是一个预后不良的指标，这些患者在治疗后更有可能复发。疾病的复发或进展最有可能发生在治疗后 2 年内。因此，在此期间应密切监测患者。
4 Laryngoscope, 131:E2525-E2533, 2021.
