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摘要
鼻腭管囊腫(nasopalatine duct cyst)是最常見的上頜非齒源性囊腫。臨床上，它通常是一個上頜中央門齒後方的不對稱腫塊，主要是因鼻腸管未能融合在一起所產生，症狀以腭部腫大最常見。根據文獻報告，只有10%的鼻腭管囊腫直徑大於30毫米；而造成鼻塞及上頜骨質破壞者更是罕見。治療方法以手術切除為主。本院於2001年5月經歷1例，患者為27歲男性，主訴為過去2個月有鼻塞及口腔上方異物感。理學檢查發現兩側鼻腔底部有不對稱隆起，且硬腭前端有一柔軟腫塊，外觀與周邊口腔粕膜同呈粉紅色。電腦斷層顯示硬腭有一28×28×33mm低密度圓形病灶，且合併周圍上頜骨質的破壞。因囊腫甚大，經施予經腭及唇下路徑完整剜出囊腫。術後病理報告為一同時具呼吸、立方及鱗狀上皮之囊腫。根據病灶位置、影像檢查及組織學發現，確定診斷為鼻腭管囊腫。追蹤迄今1年無復發的現象。
並列摘要
The nasopalatine duct cyst (NPDC) is the most common cyst of a nonodontogenic origin in the maxilla. In reviewing the literature, there were only 10% of the NPDCs greater than 30mm in diameter. Besides these, NPDCs with nasal obstruction and bony destruction of maxilla were rarely seen. Clinically, it is an asymmetrical mass resulting largely from unfused nasopalatine duct behind the maxillary central incisors. Palatal soft-tissue swelling is the most commonly encountered symptom. The major treatment for NPDC is surgical excision via a palatal flap procedure. We had a case of a 27 y/o male with chief complaints of nasal obstruction and foreign body sensation over the upper oral cavity for 2 months in May 2001. However, he could also feel fluctuation when touching the hard palate with the tongue tip. In physical examination, asymmetric protrudent floor of the nasal cavity and soft mass of the median palatine region were found. CT of the paranasal sinus showed a 28×28×33mm hypodense lesion inducing bony destruction of the maxilla and mass effect of nasal cavity. Owing to the huge size of the cyst, we performed a transpalatal-sublabial enucleation of the nasopalatine duct cyst for this patient. According to the location, image examination and histological findings of the lesion, the nasopalatine duct cyst was finally diagnosed. No recurrences occurred after 12 months follow-up. This example shows that NPDCs may also be present with nasal obstruction and bony destruction of the maxilla.
延伸閱讀
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- 翁英哲、林清榮、李永賢、張斌（1992）。鼻腔及鼻竇之腺樣囊狀癌。中華民國耳鼻喉科醫學會雜誌，27(4)，328-334。https://doi.org/10.6286/1992.27.4.328
- 陳泰岳、楊宗翰、李明儒、黃弘孟（2008）。長於鼻腔及鼻竇內的囊腫樣乳突瘤。北市醫學雜誌，5(1)，123-127。https://doi.org/10.6200/TCMJ.2008.5.1.13
- Lin, C. S., & Wang, H. W. (2004). 鼻內視鏡治療外科手術後上頜竇囊腫. Journal of Medical Sciences, 24(6), 339-341. https://www.airitilibrary.com/Article/Detail?DocID=10114564-200412-201305090003-201305090003-339-341
- Li, Y. P., Lin, J. C., Chou, Y. P., & Chu, C. K. (2018). An Unusual Giant Thymic Cyst. 胸腔醫學, 33(5), 215-220. https://www.airitilibrary.com/Article/Detail?DocID=10239855-201810-201809270005-201809270005-215-220