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慢性根尖周围炎并发皮瘘在口腔疾患中并不少见,其特点为感染的来源是患有慢性根尖周围炎的牙齿,然而病损是在颌面部或颏部皮肤处产生开口。我们曾见到被误诊为疖子、脂肪瘤、淋巴结核、骨髓炎、放线菌病、泪囊瘘等,虽经手术、抗结核治疗,服用大量抗生素亦经久不愈。病程有的长达数年之久,给患者带来莫大的痛苦。如果对皮瘘能做出正确的诊断,其治疗并不困难,可在数周内治愈。为了进一步提高对本病的认识,现将我科半年中收治的5例报告如下。[例1] 男性,40岁。主诉9个月来左面颊部有“肿物”,半月前破溃,出脓血不愈。9个月前发现左颊部肿胀,不久即出现一黄豆大“肿物”,逐渐增大。曾在某医院外科经口服消炎药、注射抗生素治疗无效,一个月前在口腔外科就诊,诊断为“脂肪瘤”,嘱做手术切除,患者未接受治疗,半个月后“肿物”自行破溃而出脓血来我科就诊。检查:左侧面颊部
Chronic periapical dermatitis with concurrent fistulas is not uncommon in oral disorders and is characterized by the source of the infection being teeth with chronic periapical inflammation, however the lesion is an opening at the maxillofacial or chin skin. We have seen misdiagnosed as prickly heat, lipoma, lymph node tuberculosis, osteomyelitis, actinomycosis, lacrimal sac fistula, although by surgery, anti-TB treatment, take a lot of antibiotics also prolonged unhealed. Some course of up for several years, to patients with great pain. If the fistula can make the correct diagnosis, the treatment is not difficult, can be cured within a few weeks. In order to further enhance the understanding of the disease, now five cases admitted to our department in the report of 5 cases are as follows. [Example 1] Male, 40 years old. Chief complaint nine months left cheek Department have “tumor”, half a month ago rupture, a sepsis. Nine months ago found that the left cheek swelling, soon appeared a big soy “tumor”, gradually increased. Once in a hospital surgery by oral anti-inflammatory drugs, antibiotic treatment is invalid, a month ago in oral surgery, diagnosis of “lipoma”, ordered surgical resection, the patient did not receive treatment, two weeks after the “tumor” self-broken Ulceration out of sepsis to our department. Check: left cheek