上頜竇膽脂瘤—病例報告

上頜竇膽脂瘤（cholesteatoma of the maxillary sinus），又稱為角質瘤（keratoma）、角質囊腫（kerato-cyst）、表皮樣囊腫（epidermal cyst），相當罕見，根據文獻索引，全世界已報導病例共只有44例，本院在2001年9月間有1名36歲男性病人，因為長期鼻塞至本院門診求診，經前鼻鏡檢查，發現左側中鼻道被一蒼白的腫塊堵塞，電腦斷層則顯示左側上頜竇被一包膜完整的球狀腫瘤佔據，經鼻竇內視鏡手術摘除，病理報告為上頜竇膽脂瘤，追蹤至今，病患情形良好，無併發症的產生。由於案例罕見，特此提出報告，並就過去的文獻，討論此病的成因、診斷及處置等。

關鍵字

上頜竇；膽脂瘤；角質瘤；角質囊腫；上皮囊腫

並列摘要

Cholesteatoma of the maxillary sinus is rare. There are approximately 44 cases reported in the world literature. The most frequent symptoms and signs at presentation are nasal obstruction, rhinorrhea, headache, facial swelling and tenderness. It's difficult to be diagnosed just with a clinical presentation and radiologic findings. A 36-year old man visited our hospital with the symptom of left nasal obstruction for 3 months. Anterior rhinoscopy showed a pale polypoid-like mass over left nasal cavity. A CT scan of the paranasal sinuses showed a large, homogeneous, expansile mass over left maxillary anturum. Endoscopic sinus surgery was performed to remove the maxillary sinus mass. The pathology showed a maxillary sinus cholesteatoma. Recurrence has not occurred during the 6-month follow-up. In the reported cases, most surgeons suggested Caldwell-Luc operation with complete cholesteatoma excision. Although our patient still requires long term follow-up in view of the risk of recurrence and malignant transformation, we recommend that endoscopic sinus surgery is a good option for cholesteatoma of the maxillary sinus.

並列關鍵字

maxillary sinus ； cholesteatoma ； keratoma ； keratocyst ； epidermal cyst

國際替代計量

上頜竇膽脂瘤—病例報告

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