Fang Cheng,Dong Chenbin,Li Jun,et al.Analysis of clinical characteristics of craniofacial non-midline dermoid cyst: a report of 109 children[J].Journal of Clinical Pediatric Surgery,2022,21(06):567-570.[doi:10.3760/cma.j.cn101785-202007037-013]
颅面非中线皮样囊肿109例临床特点及诊治分析
- Title:
- Analysis of clinical characteristics of craniofacial non-midline dermoid cyst: a report of 109 children
- Keywords:
- Dermoid Cyst/DI; Dermoid Cyst/SU; Face/PA; Skull/PA; Bones/PA
- 摘要:
- 目的 总结颅面非中线皮样囊肿的临床特点及诊治经验。方法 以2016年1月至2019年12月在复旦大学附属儿科医院整形外科行手术治疗的109例颅面非中线皮样囊肿患儿为研究对象,按骨质改变情况分为骨质改变组与骨质未改变组,对两组患儿性别、发现症状时年龄、手术年龄、囊肿位置、囊肿活动度及囊肿大小进行分析。结果 骨质改变组发现症状时年龄为(0.64±0.21)岁,而骨质未改变组为(1.39±2.19)岁,差异有统计学意义(t=2.871,P=0.005);囊肿活动度差者合并骨质改变的发生率为43.6%(17/39),囊肿活动度好者合并骨质改变的发生率为10.0%(7/70),差异有统计学意义(χ2=16.458,P<0.001);骨质改变组与骨质未改变组在性别、囊肿位置、手术年龄以及囊肿大小上比较,差异无统计学意义(P>0.05)。结论 颅面非中线皮样囊肿患儿体格检查囊肿活动度差,高度提示存在骨质改变,推荐术前行CT或MRI检查以了解肿物与骨质情况;术中注意探查囊肿底部,完整切除肿物。
- Abstract:
- Objective To summarize the clinical characteristics and management strategies of craniofacial non-midline dermoid cyst.Methods From January 2016 to December 2019, 109 surgical children of craniofacial non-midline dermoid cysts were divided into two groups of bone change and bone non-change according to the degree of bone alteration.Analyses were performed for such factors as gender, onset age, surgical age, cyst location, cyst mobility and cyst size, etc.Results Onset age was (0.64±0.21) years in bone change group and (1.39±2.19) years in bone non-change group.And the difference was statistically significant (t=2.871, P=0.005).The incidence of cysts with poor mobility plus bone changes was 43.6% (17/39) while the incidence of cysts with good mobility plus bone change 10.0%(7/70).And the difference was statistically significant (χ2=16.458, P<0.001).Gender, cyst location, operative age or cyst size had no effect on the occurrence of craniofacial non-midline dermoid cysts with bone changes (P>0.05).Conclusion During physical examinations, poor mobility of craniofacial non-midline dermoid cyst is highly suggestive of bone changes.Computed tomography or magnetic resonance imaging is recommended preoperatively for grasping the conditions of tumor and bone.During operation, surgeons should pay close attention to a complete resection of tumor, especially bottom exploration.
参考文献/References:
[1] Paradis J, Koltai PJ.Pediatric teratoma and dermoid cysts[J].Otolaryngol Clin North Am, 2015, 48(1):121-136.DOI:10.1016/j.otc.2014.09.009.
[2] 谭艺兰, 罗俊, 郭燕, 等.儿童眶周皮样囊肿114例临床分析[J].国际眼科杂志, 2015, (8):1475-1477.DOI:10.3980/j.issn.1672-5123.2015.8.48.Tan YL, Luo J, Guo Y, et al.Clinical analysis of periorbital dermoid cyst in children:a report of 114 cases[J].International Eye Science, 2015, (8):1475-1477.DOI:10.3980/j.issn.1672-5123.2015.8.48.
[3] Vega RA, Hidlay DT, Tye GW, et al.Intradiploic dermoid cyst of the lateral frontotemporal skull:case report and review of the literature[J].Pediatr Neurosurg, 2013, 49(4):232-235.DOI:10.1159/000363329.
[4] Khalid S, Ruge J.Considerations in the management of congenital cranial dermoid cysts[J].J Neurosurg Pediatr, 2017, 20(1):30-34.DOI:10.3171/2017.2.PEDS16701.
[5] Overland J, Hall C, Holmes A, et al.Risk of intracranial extension of craniofacial dermoid cysts[J].Plast Reconstr Surg, 2020, 145(4):779e-787e.DOI:10.1097/PRS.0000000000006655.
[6] Choi JS, Bae YC, Lee JW, et al.Dermoid cysts:Epidemiology and diagnostic approach based on clinical experiences[J].Archives of Plastic Surgery, 2018, 45(6):512-516.DOI:10.5999/aps.2018.00017.
[7] Van Kouwenberg E, Kanth AM, Mountziaris P, et al.Cranial erosion associated with non-midline dermoid cysts in the pediatric population[J].J Craniofac Surg, 2019, 30(16):1760-1763.DOI:10.1097/SCS.0000000000005317.
[8] Prior A, Anania P, Pacetti M, et al.Dermoid and epidermoid cysts of scalp:case series of 234 consecutive patients[J].World Neurosurg, 2018, 120:119-124.DOI:10.1016/j.wneu.2018.08.197.
[9] Hou JH, Aakalu VK, Setabutr P.Quantitative characterization of growth rate of an incidental deep dermoid cyst in a child using sequential magnetic resonance imaging[J].J AAPOS, 2012, 16(4):403-405.DOI:10.1016/j.jaapos.2012.04.007.
[10] 祝永杰, 王刚, 何俊平, 等.儿童头皮和颅骨皮样囊肿的临床特点和手术疗效[J].中华神经外科杂志, 2019, 35(8):802-806.DOI:10.3760/cma.j.issn.1001-2346.2019.08.010.Zhu YJ, Wang G, He JP, et al.Clinical characteristics and surgical efficacy of dermoid cysts of scalp and skull in children[J].Chinese Journal of Neurosurgery, 2019, 35(8):802-806.DOI:10.3760/cma.j.issn.1001-2346.2019.08.010.
[11] Mejdoubi M, Arne JL, Sevely A.Orbital tumors in children:CT and MR imaging features[J].J Radiol, 2007, 88(12):1855-1864.DOI:10.1016/s0221-0363(07)78363-4.
[12] 张兴强, 谭必勇, 李胜, 等.头皮良恶性肿块临床与CT鉴别诊断[J].医学影像学杂志, 2016, 26(12):2198-2202.Zhang XQ, Tan BY, Li S, et al.Clinical and CT differential diagnosis of benign and malignant scalp masses[J].Journal of Medical Imaging, 2016, 26(12):2198-2202.
[13] Chang JW, Yoon JS, Lee JH.The appropriate surgical approach to frontotemporal dermoid cysts in adult patients[J].Ann Plast Surg, 2017, 78(1):54-58.DOI:10.1097/SAP.0000000000000755.
[14] 刘世杰.眉弓外侧皮样囊肿手术治疗体会[J].实用口腔医学杂志, 2008, 24(5):668.DOI:10.3969/j.issn.1001-3733.2008.05.036.Liu SJ.Experience in surgical treatment of dermoid cysts on lateral brow arch[J].Journal of Practical Stomatology, 2008, 24(5):668.DOI:10.3969/j.issn.1001-3733.2008.05.036.
[15] Eldesouky MA, Elbakary MA.Orbital dermoid cyst:classification and its impact on surgical management[J].Semin Ophthalmol, 2018, 33(2):170-174.DOI:10.1080/08820538.2016.1182636.
备注/Memo
收稿日期:2021-07-16。
通讯作者:董晨彬,Email:dcb426@163.com