目标:在现有文献的基础上,关于无症状的增长率,偶然发现鼻旁窦(PNS)骨瘤,评估与增长率相关的潜在因素,并提出如何跟进的论点。
方法:在我们的机构,EPICSlicerDicer用于使用关键字\'骨瘤\'筛选影像学研究,并包括间隔6个月进行至少2项影像学研究的患者,均显示PNS骨瘤。选择具有最大时间间隔的成像研究。非PNS骨瘤被排除。
结果:47例符合该标准的患者,中位间隔成像时间为35.9个月。经测,头尾方向生长率为0.39mm/年,中外侧方向生长率为0.45mm/年,一起平均0.42毫米/年。此外,增长率的增加似乎不会影响发展为包括鼻息肉病或慢性鼻窦炎和症状如窦压的可能性,头痛,鼻后滴漏,或拥堵。发现间隔扫描>36个月的那些比间隔扫描更紧密的那些具有较慢的生长速率。此外,以前吸烟者和现在吸烟者的生长速度明显高于不吸烟者.
结论:鉴于其缓慢的增长率,我们得出结论,选择的病变可能不需要随访.如果担心生长会导致阻塞性并发症,例如阻塞额叶流出道,我们认为一年一次扫描是合适的。如果此扫描有额外的增长,可进行长达3年的监测扫描以评估稳定性.最后,虽然吸烟者与非吸烟者相比有显著的增长率,缓慢的增长率不太可能影响管理。
OBJECTIVE: To build upon existing literature regarding growth rate of asymptomatic, incidentally found paranasal sinus (PNS) osteomas, evaluate potential factors associated with growth rate and present an argument for how to follow up.
METHODS: At our institution, EPIC SlicerDicer was used to screen imaging studies using keyword \'osteoma\' and included patients with at least 2 imaging studies 6 months apart that both demonstrated a PNS osteoma(s). Imaging studies with the largest time interval were selected. Non-PNS osteomas were excluded.
RESULTS: 47 patients that fit this criterion with a median duration of interval imaging of 35.9 months. Growth rate was measured to be 0.39 mm/year in the cephalocaudal direction and 0.45 mm/year in the mediolateral direction, together averaging 0.42 mm/year. Increases in growth rate additionally did not appear to impact the likelihood of developing conditions including nasal polyposis or chronic sinusitis and symptoms such as sinus pressure, headache, postnasal drip, or congestion. Those with interval scans >36 months were found to have a slower growth rate than those with closer interval scans. Furthermore, former smokers and current smokers had significantly greater growth rates than nonsmokers.
CONCLUSIONS: Given their slow growth rate, we conclude that select lesions likely do not require follow-up. If there is concern that growth could cause an obstructive complication, such as blocking the frontal outflow tract, we argue a single scan at one year is appropriate. If there is additional growth on this scan, surveillance scans up to 3 years could be performed to assess stability. Lastly, while there was a significant growth rate for smokers compared to non-smokers, the slow growth rate is unlikely to influence management.