Yılmaz Topçuoğlu Miray-Su, Plinkert Peter K, Seitz Angelika, El Damaty Ahmed, Bächli Heidrun, Baumann Ingo
Department of Otorhinolaryngology, University Hospital Heidelberg, Heidelberg, Germany.
Department of Neuroradiology, University Hospital Heidelberg, Heidelberg, Germany.
Ann Otol Rhinol Laryngol. 2025 Mar;134(3):218-224. doi: 10.1177/00034894241300801. Epub 2024 Nov 29.
Midline nasal masses are rare and challenging for surgeons. This study examined the site with the highest risk of recurrence following midline nasal mass excisions.
Surgical outcomes were retrospectively reviewed following excision of midline nasal masses between 2010 and 2022 in the predominantly pediatric patient cohort. The primary outcome measure was the recurrence rate.
Overall, 22 nasal masses were resected from 20 patients. Of these masses, 16 were nasal dermoid sinus cysts (NDSC), 2 were hamartomas, 1 was an epidermoid cyst, and 1 was a mature teratoma. Five of the nasal masses were classified as intracranial lesions, 11 were classified as intraosseous lesions, and 6 were classified as superficial lesions. The open rhinoplasty approach was chosen in 65% of the surgeries. For the intracranially extended lesions, a combined nasocranial approach was performed. Four revision surgeries were performed due to superficial recurrences at the nasal dorsum of lesions, that were primarily classified as intraosseous lesions.
All recurrences had a superficial extension and were easily excised. Intraosseous NDSC have the highest risk of recurrence, but conversely, they also occur most frequently.
中线鼻腔肿物较为罕见,对外科医生来说具有挑战性。本研究调查了中线鼻腔肿物切除术后复发风险最高的部位。
对2010年至2022年期间主要为儿童患者队列中行中线鼻腔肿物切除术后的手术结果进行回顾性分析。主要观察指标为复发率。
总体而言,从20例患者身上切除了22个鼻腔肿物。其中,16个为鼻皮样窦囊肿(NDSC),2个为错构瘤,1个为表皮样囊肿,1个为成熟畸胎瘤。5个鼻腔肿物被归类为颅内病变,11个被归类为骨内病变,6个被归类为浅表病变。65%的手术采用了开放式鼻整形术入路。对于颅内扩展病变,采用了鼻颅联合入路。因病变鼻背浅表复发进行了4次翻修手术,这些病变主要归类为骨内病变。
所有复发均有浅表扩展,且易于切除。骨内NDSC复发风险最高,但相反,其发生频率也最高。