摘要
背景：鼻及鼻竇血管瘤是造成單側鼻塞以及單側鼻韌血可能的原因。本研究主要探討近7年來童綜合醫院鼻及鼻竇血管瘤的病人臨床症狀、治療及預後。方法：以病例回溯的方式，將近7年所有在童綜合醫院診斷為鼻及鼻竇血管瘤的案例，納入研究。所蒐集的資料包括：病患的性別、年齡、血管瘤的位置、大小、影像檢查、手術方式、術中出血量、病理學檢查結果及預後分析統計。結果：共10名病患納入研究。依據血管瘤的組織型態分類，其中小葉微血管性血管瘤有6例，海綿狀血管瘤有3例以及1例未分類血管瘤。年齡分佈方面，最小的是9歲，最大的是80歲，平均年齡為55歲。而發生的部位，發生在下鼻甲有4例，鼻中膈有3例，鼻竇有2例，以及中鼻甲有1例。而血管瘤的大小，最長徑從0.5 cm到5 cm。所有個案均接受內視鏡檢查，其中4例接受電腦斷層檢查以及1例接受血管攝影檢查併栓塞。所有個案均接受鼻竇內視鏡手術切除。在1到6年的門診追蹤中，均無術後出血或復發的情形。結論：我們建議所有無法確定範圍的鼻及鼻竇血管瘤在術前都應接受電腦斷層或核磁共振檢查。如果鼻及鼻竇血管瘤在一開始檢查時就很大或是在切片時非常容易出血，則建議應在術前接受血管攝影檢查併栓塞，以避免術中大量出血。
並列摘要
BACKGROUND: Sinonasal hemangiomas may be causes of unilateral nasal bleeding and nasal obstruction. The purpose of this study was to analyze the clinical manifestations, treatment and prognosis of patients with sinonasal hemangiomas.METHODS: All cases of sinonasal hemangiomas diagnosed at Tungs' Taichung MetroHarbor Hospital in recent 7 years were identified and analyzed retrospectively. Data collected including: patients' sex, age, tumor location, tumor size, image study, operation method, blood loss during operation, histopathology results, and prognosis were reviewed where available.RESULTS: Ten cases of sinonasal hemangiomas were identified in our hospital. Among the hemangiomas classified histopathologically, there were 6 cases of lobular capillary hemangioma, 3 cases of cavernous hemangioma, and 1 case of uncategorized hemangioma. The patients were aged between 9 and 80 years, and the mean age was 55 years. Regarding the locations of the hemangiomas, 4 cases occurred over the inferior turbinate, 3 cases occurred over the nasal septum, 2 cases occurred in the paranasal sinuses and 1 case occurred at the middle turbinate. The size of the sinonasal hemangioma of our patients ranged from 0.5 cm to 5 cm. Among the ten cases, all cases received endoscope examination, 4 cases underwent CT scan, and 1 case received angiographic embolization. All cases underwent sinonasal endoscopic surgery excision. All cases were without post-operation bleeding or recurrence during 1 month to 5 years of patient follow up.CONCLUSIONS: We recommend that all patients with suspected sinonasal hemangiomas with an undefined area receive a CT or MRI scan for evaluation before surgery. If a huge sinonasal hemangioma is noted or a severe bleeding tendency is found at biopsy, angiographic embolization is suggested prior to surgical excision.
延伸閱讀
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