儿童鼻腔牙1例并文献复习

Nasal teeth in children (Report of one case with literature review)

摘要:

目的探讨儿童鼻腔牙的临床特点，并对儿童鼻腔牙的相关文献进行复习，以提高临床医师对儿童鼻腔牙的临床认识与诊治水平。方法患儿男，4岁5个月，因右侧持续鼻塞1个月而入院，经CT及MRI提示右侧鼻腔异物，两次全麻鼻内镜下行鼻腔及鼻咽部探查术。结果第1次探查未见异常，术后右侧鼻塞未见缓解；第2次术中切除右侧鼻腔底壁牙样物，术后鼻塞缓解，5 d后鼻塞消失，病检示右侧鼻腔组织部分被覆鳞状上皮并呈息肉状增生，另一组织形似牙组织。随访1年3个月未见复发。结论儿童鼻腔牙罕见，临床可表现为鼻塞、鼻出血等，需与鼻腔异物、鼻石、肿瘤相鉴别，鼻内镜下手术切除是其安全有效的治疗手段。

关键词:鼻腔牙|儿童|文献复习

Abstract:

ObjectiveTo explore the clinical manifestations and management of nasal teeth (NT) in children so as to improve clinicians’ level for the recognition, diagnosis and treatment of NT.MethodsOne child with NT was reported and related literature of NT was reviewed. The male patient of 4 years and 5 months old was admitted due to persistent nasal obstruction for one month. Computed tomography (CT) and magnetic resonance imaging (MRI) of the paranasal sinuses showed a radioopaque mass in the floor of the right nose. Nasal endoscopic exploration of nasal cavity and nasopharynx under general anesthesia was applied to the patient twice.ResultsThe first exploration didn’t find any abnormality, and nasal obstruction wasn’t relieved after the first exploration. During the second exploration, a toothlike mass was found and extracted endoscopically. Nasal obstruction was immediately relieved after operation and disappeared 5 days after surgery. Postoperative followup for one year and three months showed no recurrence.ConclusionsNT is extremely rare in children. With varied clinical manifestations such as nasal obstruction and epistaxis, NT should be differentiated from foreign body, rhinolith and tumor. Extraction of the NT under endoscope is safe and effective.

Key words:Nasal tooth|Child| Literature review