摘要
目的探讨孤立性蝶窦病变的临床特征,诊断及合理治疗方法,提高首诊准确率和治愈率。方法分析本院2006年12月—2011年12月收治的41例孤立性蝶窦病变患者的临床表现、影像学特点、鼻内镜检查特点以及鼻内镜手术治疗效果。结果该病主要症状为头痛和视力障碍;影像学检查见蝶窦占位;病理检查显示:蝶窦炎8例,真菌性蝶窦炎21例,蝶窦囊肿9例,蝶窦息肉2例,蝶窦鳞癌1例。全部患者经鼻内镜蝶窦开放术。随访半年以上,绝大部分患者症状明显好转,检查蝶窦开口通畅,窦腔无分泌物,窦壁光滑。1例蝶窦鳞癌病人术中只行活检,未完全切除肿块。结论孤立性蝶窦病变临床症状无特异性表现,对该病认识不足是导致误诊的主要原因。CT、MRI和鼻内镜检查提高了孤立性蝶窦病变的诊断水平,经鼻内镜蝶窦手术治疗孤立性蝶窦病变可获得良好的效果。
Objective To explore the clinical features of disease of solitary sphenoid sinus and improve the ability of diagnosis and treatment. Methods Clinical representation, imaging fea- tures, endoscopic features and endoscopic surgical of 41 cases with isolated sphenoid sinus diseases from Decmber 2006 to December 2011 in our department were retrospectively analyzed. Results The main symptoms were headache and visual lesion. Medical image showed pace occupying lesion. Pathological exams showed 8 cases with sphenoiditis, 19 cases with fungal infection, 9 cases with cysts and 2 cases with polyposis. 1 case with Squamous cell carcinoma. All the patients underwent open sphenoidal surgery with nasal endoscope. After a follow-up of over 6 months, most of the pa- tients symptoms had been obviously relieved. And the entrance to sphenoid was patent with smooth sinus wall and no secretion in sinus cavity. 1 case of sphenoid sinus Squamous cell carcinoma patient underwent only biopsy during operation without complete tumor dissection. Conclusion Isolated sphenoid sinus disease is difficult to be diagnosed because of its non-specific symptoms. Lack of un- derstanding of the disease is a main reason that induces the misdiagnosis of the isolated sphenoid si- nus lesions. CT, MRI and endoscopic examinations can improve the diagnostic level of the isolated sphenoid lesion and endoscope sinus surgery is valuable in diagnosis and treatment of isolated sphe- noid sinus disease.
出处
《实用临床医药杂志》
CAS
2013年第1期101-102,105,共3页
Journal of Clinical Medicine in Practice
关键词
蝶窦病变
鼻内镜
影像学检查
sphenoidal sinus disease
nasal endoscope
imaging examination
