Aged ; Female ; Fibroma ; pathology ; Fibroma, Ossifying ; pathology ; Gingival Neoplasms ; pathology ; Humans

A 39 years old male patient was admitted with the right of facial abnormalities and gradually protruding in right eye more than 30 years. CT shows high mixed density, clear boundary, and the right eye was crowded to the right. Giant tumor had completely been excised, and the result was fine. The outline figure and function of patients were obviously improved. The pathological examination after resection showed ossifying fibroma.
Adult ; Fibroma, Ossifying ; diagnosis ; Humans ; Male ; Nasal Cavity ; pathology ; Paranasal Sinus Neoplasms ; diagnosis ; Paranasal Sinuses ; pathology

Fibro-osseous lesions is a class of diseases with obvious similarities in clinical manifestations and pathological features, which has been attracting the attention of clinicians and pathologists. The latest WHO 2022 Classification (5th edition) included six of these diseases (cemento-osseous dysplasia, segmental odontomaxillary dysplasia, fibrous dysplasia, juvenile trabecular ossifying fibroma, psammomatoid ossifying fibroma and familial gigantiform cementoma) in the " fibro-osseous tumours and dysplasias ", and put forward new ideas on the diagnosis and treatment of these diseases. According to the latest WHO 2022 Classification (5th edition), the clinical and pathological features, diagnosis and differential diagnosis of these six diseases were described.
Humans ; Fibroma, Ossifying/pathology* ; Diagnosis, Differential ; Cementoma/pathology* ; Jaw Neoplasms ; Facial Bones

Aged ; Back ; pathology ; CD57 Antigens ; metabolism ; Chondrosarcoma ; metabolism ; pathology ; Diagnosis, Differential ; Fibroma, Ossifying ; metabolism ; pathology ; Humans ; Male ; Phosphopyruvate Hydratase ; metabolism ; S100 Proteins ; metabolism ; Soft Tissue Neoplasms ; metabolism ; pathology

OBJECTIVE: To explore the use of transnasal endoscopy and open surgical approaches for management of sinonasal and adjacent skull base benign fibro-osseous lesions, the surgical methods, precautions, clinical efficacies were also described. METHOD: Fifteen patients were reviewed, including osteoma in 6 cases, Ossifying fibroma in 2 cases and fibrous dysplasia in 7 cases. Analyzed the pathological features and CT images, and to select surgical approach according to the location and extent of lesions. Eleven patients were operated through transnasal endoscopic procedure, including 7 cases with ipsilateral nasal approach and 4 cases with extended binasal approach; 4 cases with open surgical approach, including trans-eyebrow approach in 1 case and bicoronal approach in 3 cases. RESULT: All patients were followed up for 2 months to 4 years, gross resection of lesions in 10 cases but partial resection in 5 cases with fibrous dysplasia. The clinical symptoms and facial deformity in all cases were eliminated or significantly relieved postoperatively. Cerebrospinal fluid leakage occurred in 1 case, was successfully repaired during the endoscopic operation. Preoperative diplopia in 3 cases, 2 cases disappeared after six months, one case was improved significantly. There were no postoperative orbital or intracranial complications. CONCLUSION Surgery is an effective means to resect lesions which had obviously clinical symptoms. The location and extent of lesions were the decisive factor to choose an open or endoscopic approach. Endoscopic sinus surgery can manage the midline skull base lesions which extend from the posterior wall of the frontal sinus to the clivus, well the open surgical approach is suitable for lesions locating the area beyond the medial orbital wall. No matter choosing which approach, osteoma, ossifying fibroma can be completely removed. For the fibrous dysplasia, as an extensive but self-limiting lesion, the surgery is performed only for relieving symptoms and facial deformity. So the partial resection is preferred and reasonable other than radical total resection. Even the severe fibrous dysplasia lesions caused the optic canal stenosis but present normal vision, it is unnecessary to perform prophylactic decompression of the optic nerve.
Adolescent ; Adult ; Aged ; Endoscopy ; Female ; Fibroma, Ossifying ; pathology ; surgery ; Humans ; Male ; Middle Aged ; Osteoma ; surgery ; Paranasal Sinuses ; pathology ; Skull Base ; pathology ; Young Adult

Arrested pneumatization of the sphenoid sinus is a developmental variant that is not always well recognized and is often confused with other pathologies associated with the skull base. This report describes the case of a patient referred for cone-beam computed tomography (CBCT) imaging for dental implant therapy. CBCT demonstrated a well-defined incidental lesion in the left sphenoid sinus with soft tissue-like density and sclerotic borders with internal curvilinear opacifications. The differential diagnoses included intraosseous lipoma, arrested pneumatization of the sphenoid sinus, chondrosarcoma, chondroid chordoma, and ossifying fibroma. The radiographic diagnosis of arrested pneumatization was based on the location of the lesion, its well-defined nature, the presence of internal opacifications, and lack of expansion. Gray-scale CBCT imaging of the area demonstrated values similar to fatty tissue. This case highlighted the fact that benign developmental variants associated with the skull base share similar radiographic features with more serious pathological entities.
Adipose Tissue ; Chondrosarcoma ; Chordoma ; Cone-Beam Computed Tomography ; Dental Implants ; Diagnosis ; Diagnosis, Differential ; Fibroma, Ossifying ; Humans ; Lipoma ; Pathology ; Skull Base* ; Sphenoid Sinus*

OBJECTIVE: To review endonasal endoscopic surgeries aided by Fusion image guided system, and to explore the application value of Fusion image guided system in endonasal endoscopic surgeries. METHOD: Retrospective research. Sixty cases of endonasal endoscopic surgeries aided by Fusion image guided system were analysed including chronic rhinosinusitis with polyp (n = 10), fungus sinusitis (n = 5), endoscopic optic nerve decompression (n = 16), inverted papilloma of the paranasal sinus (n = 9), ossifying fibroma of sphenoid bone (n = 1), malignance of the paranasal sinus (n = 9), cerebrospinal fluid leak (n = 5), hemangioma of orbital apex (n = 2) and orbital reconstruction (n = 3). RESULT: Sixty cases of endonasal endoscopic surgeries completed successfully without any complications. Fusion image guided system can help to identify the ostium of paranasal sinus, lamina papyracea and skull base. Fused CT-CTA images, or fused MR-MRA images can help to localize the optic nerve or internal carotid arteiy . Fused CT-MR images can help to detect the range of the tumor. It spent (7.13 ± 1.358) minutes for image guided system to do preoperative preparation and the surgical navigation accuracy reached less than 1mm after proficient. There was no device localization problem because of block or head set loosed. CONCLUSION Fusion image guided system make endonasal endoscopic surgery to be a true microinvasive and exact surgery. It spends less preoperative preparation time, has high surgical navigation accuracy, improves the surgical safety and reduces the surgical complications.
Cerebrospinal Fluid Leak ; surgery ; Endoscopy ; instrumentation ; Fibroma, Ossifying ; surgery ; Humans ; Nasal Surgical Procedures ; methods ; Neurosurgical Procedures ; Nose ; pathology ; Papilloma, Inverted ; surgery ; Paranasal Sinuses ; pathology ; Retrospective Studies ; Sinusitis ; surgery ; Sphenoid Bone ; pathology ; Surgery, Computer-Assisted ; methods

OBJECTIVETo discuss the indication, efficacy and safety of endoscopic minimally invasive surgery technique in the management of nasal skull-base neoplasms.

METHODSThirty-six patients with nasal skull base neoplasms were treated from January 2000 to Jun 2004 under nasal endoscopy, including 16 nasopharyngeal fibroangioma, 8 sinus osteofibroma, 8 pituitary adenoma, 4 olfactory neuroblastoma. Pathology lab procedures were performed pre or post-operatively. The feeding artery of nasopharyngeal fibroangioma was selectively embolized with gelatin sponge before operation. All olfactory neuroblastoma and 2 pituitary adenoma received radiotherapy after operation.

RESULTSTotal or most of nasopharyngeal fibroangioma, sinus osteofibroma, olfactory neuroblastoma and pituitary adenoma were excised. Three cases presented complications of cerebrospinal fluid leakage, 2 cases were successfully mended with middle turbinate and muscle tissue respectively, another one gained self-healing after reducing the intracranial pressure and anti-inflammation. Followed up 4 to 8 years without recurrence for all patients. Seldom serious complications accrued.

CONCLUSIONSWhen the indications are selected appropriately, nasal skull-base neoplasms, including benign and malignant, can be well treated with nasal endoscopic minimally invasive surgery.

Adolescent ; Adult ; Aged ; Child ; Endoscopy ; Female ; Fibroma, Ossifying ; surgery ; Humans ; Male ; Middle Aged ; Minimally Invasive Surgical Procedures ; Nasopharyngeal Neoplasms ; surgery ; Neuroblastoma ; surgery ; Nose ; surgery ; Olfactory Nerve ; pathology ; Pituitary Neoplasms ; surgery ; Skull Base Neoplasms ; surgery ; Young Adult