目的:比较和分析发病率,临床特征,成像特征,术前血清碱性磷酸酶(ALP)和骨瘤复发率,骨化性纤维瘤(OF),鼻窦和颌面部良性纤维化(FOLS)的纤维发育不良(FD)。方法:对我院收治的273例鼻旁窦及颌面部FOLS,其中骨瘤153例,44例OF,和76例FD,进行回顾性审查,并随访6个月至5年。发病率,性别,年龄,病变位置,术前血清ALP水平及不同病灶复发率进行分析比较。结果:大部分骨瘤发生在鼻旁窦(72.5%),其中最常见的部分是筛窦(50.3%),其次是额窦(22.1%),男女比例为2:1,其中27例(17.7%)伴有鼻窦炎。没有患者复发。大多数OF发生在颌骨(65.9%),大多数病变为单骨(75.0%)。对于发生在鼻旁窦的那些,筛窦(27.3%)是最常见的部分。女性与男性的比例几乎为1∶1,有12例(27.3%)伴有鼻窦炎。OF的复发率为13.6%。发生在颌面部骨的FD大多数(64.5%)为单骨形式(64.5%),其中最常见的部分是上颌骨(50.0%)。同时,大多数发生在鼻旁窦的是多鼻窦,最常见部位为蝶窦(34.2%)。女性与男性的比例几乎为1∶1,有10例(13.2%)伴有鼻窦炎。复发12例(14.5%),20岁前首次手术9例(75.0%)。骨瘤的平均发病年龄[(40.7±14.55)y],OF[(28.0±17.9)y]与FD[(20.32±15.2)y]差异有统计学意义(P<0.01)。骨瘤患者术前血清ALP含量[(68.3±24.1)U/L,OF(130.1±107.0)U/L与FD(127.7±78.7)U/L有显著性差异(P<0.01)。然而,单核和多核患者术前血清ALP含量无差异[(117.2±92.6)U/L,(168.7±140.1)U/L,(P>0.01),以及FD案例之间的差异[(122.2±82.9)U/L,(137.7±70.7)U/L(P>0.01).结论:人际关系的差异,发病年龄,莱辛位置,骨瘤患者术前血清ALP含量和复发率,OF和FD具有统计学意义。手术是目前最有效的治疗方法。
Objective:To compare and analyze the incidence, clinical features ,imaging features, the preoperative serum alkalinosis phosphatase (ALP) and recurrence rates of osteoma, ossifying fibroma (OF), and fibrous dysplasia (FD) in sinus and maxillofacial benign fibrosis (FOLS). Method: The 273 cases of FOLS with paranasal sinus and maxillofacial region in our hospital, among which there were 153 cases of osteoma, 44 cases of OF, and 76 cases of FD, were reviewed retrospectively and were follow-up for 6 months to 5 years. The incidence, gender, age, lesion location, preoperative serum ALP levels and recurrence rate of different lesions were analyzed and compared. Result:Most Osteoma occurred in paranasal sinus (72.5%),among which the most common part was ethmoid sinus (50.3%) and followed by the frontal sinus (22.1%),the ratio of female to male was 2:1,and there were 27 cases (17.7%) accompanied by sinusitis.None of the patients relapsed. Most OF occurred in the maxillofaCIal bone (65.9%) and most of the lesions were monostotic (75.0%).For those occurred in the paranasal sinuses,the ethmoid sinus (27.3%)were the most common part than others. The ratio of femal to male was almost 1∶1 and there were 12 cases (27.3%) accompanied by sinusitis. The recurrence rate of the OF was 13.6%.Most FD occured in maxillofacial bone (64.5%) were the monostotic form(64.5%) ,and in which the most common part was the maxilla (50.0%). While,most of those occurred in the paranasal sinuses were the polyostotic ones,and sphenoid sinus (34.2%) were the most common parts.The ratio of femal to male was almost 1∶1 and there were 10 cases (13.2%) accompanied by sinusitis. 12 cases relapsed (14.5%),and there were 9 cases (75.0%) acceptted the first surgery before the age of 20.The average age of onset among Osteoma[(40.7±14.55)y],OF[(28.0±17.9)y] and FD[(20.32±15.2)y] were significant different (P<0.01).The preoperative serum ALP content among Osteoma[(68.3±24.1)U/L, OF(130.1±107.0) U/L and FD were (127.7±78.7) U/L significant different(P<0.01).Nevertheless,there were no differences of the preoperative serum ALP content between the monostotic and polyostotic in OF cases[(117.2±92.6) U/L,(168.7±140.1) U/L respectively,( P>0.01)],as well as that between FD cases[(122.2±82.9) U/L, (137.7±70.7) U/L (P>0.01)]. Conclusion:The differences of the inCIdence,the age of onset,leision location,preoperative serum ALP content and reccurence rate among Osteoma,OF and FD are statistically significant.Surgery is the most effective treatment at present.