Adil Eelam, Rahbar Reza
Department of Otolaryngology and Communication Enhancement, Boston Children's Hospital.
Department of Otology and Laryngology, Harvard Medical School, Boston, Massachusetts, USA.
Curr Opin Otolaryngol Head Neck Surg. 2021 Dec 1;29(6):487-491. doi: 10.1097/MOO.0000000000000765.
The aim of this study was to present the evaluation and current management of congenital paediatric nasal dermoid.
There has been a trend towards less invasive surgical excision techniques, including purely endoscopic excision, endoscopic-assisted approaches and midline excision with nasal bone osteotomies and bone flap. These approaches allow adequate access for both total resection and nasal contour and skull base reconstruction. Following resection, if nasal bone osteotomies are insufficient for restoring nasal appearance, free temporoparietal fascial graft and/or conchal cartilage can be considered. For nasal tip deformities, interdomal sutures and free fat grafting are a suitable option.
Complete surgical excision remains the treatment of choice for nasal dermoid lesions. The surgical approach taken and reconstruction depends on the type of lesion (cyst versus sinus or fistula), location (intranasal versus extranasal), whether or not there is intracranial extension, and experience of the surgical team.
本研究旨在介绍先天性小儿鼻皮样囊肿的评估及当前治疗方法。
目前存在采用侵入性较小的手术切除技术的趋势,包括单纯内镜切除、内镜辅助手术方法以及结合鼻骨截骨术和骨瓣的中线切除。这些方法为完全切除以及鼻外形和颅底重建提供了足够的手术入路。切除后,如果鼻骨截骨术不足以恢复鼻外形,可以考虑游离颞顶筋膜移植和/或耳甲软骨。对于鼻尖畸形,鼻间缝合和游离脂肪移植是合适的选择。
手术完全切除仍然是鼻皮样囊肿病变的首选治疗方法。所采用的手术入路和重建方式取决于病变类型(囊肿与窦道或瘘管)、位置(鼻内与鼻外)、是否存在颅内扩展以及手术团队的经验。