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病例报告:鼻腭管囊肿的单侧经鼻内镜袋形缝合术

Case report: Unilateral transnasal endoscopic marsupialization of nasopalatine duct cyst.

作者信息

Kagoya Ryoji, Iwanami Tomoko, Mochizuki Makoto, Kondo Kenji, Ito Ken

机构信息

Department of Otolaryngology, Faculty of Medicine, Teikyo University, Tokyo, Japan.

Department of Otorhinolaryngology-Head and Neck Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.

出版信息

Front Surg. 2022 Aug 12;9:978915. doi: 10.3389/fsurg.2022.978915. eCollection 2022.

Abstract

Nasopalatine duct cyst (NPDC) is the most common type of non-odontogenic cysts of the jaw. It has been treated with complete surgical resection using a sublabial or palatine approach. However, complete removal of the cyst can be accompanied by postoperative complications including oronasal fistula. Recently, endoscopic marsupialization for the disease has been advocated, but there are still few reports regarding the surgery. Herein, we report a case of NPDC that was treated with unilateral transnasal endoscopic marsupialization. A 43-year-old man with no relevant previous medical history was referred to our hospital for the treatment of lesion occupying the right nasal cavity. A computerized tomography scan of the sinus revealed an egg-shaped lesion with a well-defined border centered on the lower half of the nasal cavity and hard palate. Based on the site of the lesion, it was considered to be NPDC. Transnasal endoscopic marsupialization was performed to diagnose and improve nasal obstruction. Histopathological examination revealed stratified squamous epithelium without atypia, which was consistent with NPDC. Although the patient noticed paresthesia of the right upper incisor area, symptoms improved 3 months after surgery. Written informed consent was obtained from the patient for the publication of any potentially identifiable images or data included in this article. Transnasal endoscopic marsupialization for NPDC is minimally invasive and useful; however, it is necessary to build evidence for an appropriate excision range based on the position and size of the lesion.

摘要

鼻腭管囊肿(NPDC)是颌骨最常见的非牙源性囊肿类型。以往一直采用经唇下或腭部入路进行完整手术切除治疗。然而,囊肿的完整切除可能会伴有包括口鼻瘘在内的术后并发症。近来,有人主张对该病采用内镜下袋形缝合术,但关于该手术的报道仍然很少。在此,我们报告一例采用单侧经鼻内镜下袋形缝合术治疗的鼻腭管囊肿病例。一名43岁、既往无相关病史的男性因右侧鼻腔占位性病变被转诊至我院。鼻窦计算机断层扫描显示一个椭圆形病变,边界清晰,位于鼻腔下半部和硬腭中央。根据病变部位,考虑为鼻腭管囊肿。为明确诊断并改善鼻塞症状,实施了经鼻内镜下袋形缝合术。组织病理学检查显示为无异型性的复层鳞状上皮,与鼻腭管囊肿相符。尽管患者注意到右上切牙区有感觉异常,但术后3个月症状有所改善。已获得患者的书面知情同意,同意发表本文中包含的任何可能识别身份的图像或数据。经鼻内镜下袋形缝合术治疗鼻腭管囊肿具有微创性且效果良好;然而,有必要根据病变的位置和大小为合适的切除范围建立证据。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d79c/9417109/ad09146e3394/fsurg-09-978915-g002.jpg

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