摘要
目的分析颞骨巨细胞修复性肉芽肿(giant cell reparative granuloma,GCRG)的临床特点。方法回顾经病理确诊为颞骨GCRG的6例患者的临床资料,结合相关文献分析颞骨GCRG的临床特点及诊治方法。结果 6例(男、女各3例)均为单侧病变,其中有5例主要表现有听力减退,3例有耳闷胀感伴耳鸣,2例有颞区肿物伴疼痛,1例面瘫(面神经功能HBⅡ级)。3例患侧外耳道见粉红色肿物或脓性分泌物,未窥及鼓膜,2例鼓膜浑浊,1例已行鼓膜置管;鼓室导抗图1例A型,1例As型,3例C型,1例未作该检查;CT示颞骨区、颅中窝等处有膨胀性占位性病变,骨质多呈溶骨性改变;MRI示病变部位表现为T1WI和T2WI混杂低信号。所有患者行颅底、颞骨、颞下窝肿物切除术,5例经颅中窝进路、1例经颞-蝶进路完成手术;1例术后辅助放射治疗。术后病理诊断均为颞骨GCRG,随访2~3年,6例均无复发转移。结论颞骨巨细胞修复性肉芽肿临床表现多样,确诊需依靠病理学检查;治疗方法首选手术切除;当无法完全切除肿物时,术后应考虑放射治疗,预后较好。
Objective To study the clinical features of giant cell reparative granuloma in the temporal bone.Methods A retrospective analysis was performed on the clinical data of 6 cases which were confirmed by pathology with GCRG in the temporal bone.In view of the present literature,we intended to analyze the clinical features and the methods of diagnosis and treatment with GCRG in the temporal bone.Results Among the 6 patients,there were 5 cases with mainly manifested as the hearing loss,and 3 patients reported tinnitus.In addition,3 cases had the sensation of ear fullness,2 cases showed temporal bone region mass and pain.Only 1 case had facial paralysis,with facial nerve function HBII level.The patients showed dilatability space-occupying lesion and osteolytic destruction of temporal bone area,and fossa cranii media by CT.The heterogeneous low signal intensity on T1WI and T2WI were identified by MR.Complete surgical Resection was the preferential selection on 6 cases.All the patients were treated surgically by resection of masses in the skull bases,temporal bones and infra temporal fossas,5 cases were conducted via a middle cranial fossa approach and 1 case via a transsphenoidal approach.The postoperative pathological examination of the 6 cases were diagnosed as giant cell reparative granuloma of the temporal bone.Only one case received radiotherapy after surgery.No recurrences were found after a two-to-three-year follow-up.Conclusion The clinical manifestation of giant cell repair granuloma in the temporal bone is diverse and has no specificity.The definitive diagnosis still needs pathological examination to confirm.The first choice of treatment method is the complete surgical resection.The challenge of surgery is to protect the facial nerves and prevent occurrence of postoperative cerebrospinal fluid leakage.When these masses are not amenable to complete surgical removal,postoperative radiotherapy should be considered.
作者
廖卡稀
冯勃
韩东一
杨仕明
戴朴
韩维举
申卫东
刘军
赵辉
彭涛
Liao Kaxi;Feng Bo;Han Dongyi;Yang Shiming;Dai Pu;Han Weiju;Shen Weidong;Liu Jun;Zhan Hui;Peng Tao(Department of Otolaryngology-Head and Neck Surgery,Nanchong Central Hospital, The second affiliated hospital of North sichuan medical college,Nanchong,637000,China;Department of Otolaryngology-Head and Neck Surgery,PLA General Hospital, Beijing,100853,China)
出处
《听力学及言语疾病杂志》
CAS
CSCD
北大核心
2018年第5期484-487,共4页
Journal of Audiology and Speech Pathology
关键词
颞骨
巨细胞修复性肉芽肿
诊断
治疗
Temporal bone
Giant cell reparative granuloma
Diagnosis
Treatment
作者简介
廖卡稀,女,四川人,硕士研究生,主要研究方向为耳科及听力学;通讯作者:冯勃(Email:fbo301@163.com);通讯作者:彭涛(Email:9797816@qq.com)。
