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題 名 | Tophaceous Lesion of Nose with Silicone Prosthesis Implantation--Case Report=鼻部矽膠植入物周圍產生痛風石沉積--病例報告 |
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作 者 | 黃雯琪; 蕭弘道; 董光義; | 書刊名 | 臺灣整形外科醫學會雜誌 |
卷 期 | 19:4 2010.12[民99.12] |
頁 次 | 頁369-374 |
分類號 | 416.413 |
關鍵詞 | 痛風石; 鼻部矽膠植入物; Gouty tophi; Silicone nasal prosthesis; |
語 文 | 英文(English) |
中文摘要 | 背景:慢性痛風病患可在關節及軟組織處發現痛風石之沉積,尤以手指及大腳趾關節最爲常見。在某些少見的病例中,可以發現痛風石沉積在耳朵、脊髓、胰臟、甲狀軟骨、舌頭、眼睛、乳房及鼻部。目的及目標:我們報告第一例痛風石沉積於鼻部矽膠植入物周圍之病患,並討論此一情形可能發生之危險因子及因素。材料及方法:一名五十四歲女性病患發生鼻部腫痛斷續已有半年之久,依據其相關病史,她曾在十多年前接受鼻部矽膠植入物之隆鼻手術。我們以手術方式移除病患鼻部之隆起及發炎異物,在先前之矽膠植入物周圍發現疑似痛風石之沉積,矽膠植入物及痛風石皆在術中以刮除及分離的方式取出。結果:病理診斷證實沉積之發炎異物爲痛風石,術後我們給予病人適當之傷口照顧及痛風之口服藥物治療。手術部位沒有再觀察到發炎的情形。結論:鼻部整形病患日益增多,其中因爲生活方式改變而導致高尿酸血症之病人也日漸普遍。在對此族群病人進行相關之手術之前,我們應該把痛風石可能沉積而造成術後外貌改變及需要後續手術治療之可能性加以考慮。 |
英文摘要 | Background: Deposition of monosodium urate crystals in joint and soft tissue finally forms tophi in chronic gout cases. The tophaceous deposits were most commonly found around the fingers or the big toe, however in unsual cases, they could be found over other sites, such as the ears, spinal cord, pancreas, thyroid cartilage, tongue, eyes, breast and nose Aim and Objectives: We present a case with tophi formation surrounding her nasal silicone prosthesis, and this is the first case as known to the present literatures. Materials and Methods: A 54-year-old woman who had received nasal silicone implant for augmentation more than 10 years ago, came with the chief complaint of painful hump over the middle third of the nasal ridge for 6 months. Infection of prosthesis was impressed. The prosthesis was removed, and the mass of nasal hump was then removed through curettage and dissection. Cannelures were found over the silicone prosthesis. Result: Histopathologic examination revealed deposits of amorphous material, and typical birefringence of urate crystal was shown. Post operative colchicine and allopurinol were prescribed. At the last follow, which was 1 year post operation, neither wound infection nor recurrence of tophi was found. Conclusion: Implantation of prosthesis for cosmetic reason became more and more popular in modern society. As the lifestyle changes, more and more patients would confront with hyperuricemia and its series of chronic symptoms. Plastic surgeons should always take hyperuricemia into consideration, as nasal prosthesis may be a risk factor for tophi deposition. |
本系統中英文摘要資訊取自各篇刊載內容。