摘要
目的探讨引起单眼突出的鼻眼相关囊肿的优化治疗方案。方法回顾性分析2006～2012年间武汉市第一医院收治的伴有单眼突出的鼻窦眼眶区黏液囊肿患者17例,从治疗手段的选择和结果评估分析讨论该症的治疗。结果17例患者多以眼球突出伴相关症状如复视、眼球运动障碍、视力下降等首诊眼科,CT或(和)MRI检查提示鼻窦囊肿转耳鼻咽喉科治疗。CT及MRI评估显示囊肿单纯累及额窦和筛窦各1例;额窦、筛窦同时累及11例;累及额窦、筛窦及眶(眶内为独立囊肿)2例;累及额窦、筛窦及蝶窦2例,其中1例出现双侧额叶受压明显。无眶内独立囊肿患者均实施鼻内窥镜手术,选择性切除窦腔内部分囊壁,而对伴有眶内独立囊肿患者采用鼻外、鼻内联合进路手术。术后患者眼部突出及伴发症状如:复视、眼球运动障碍、视力下降等明显好转。额叶受压1例复发,采用联合进路治愈。结论鼻内镜手术是治疗引起单眼突出的鼻窦囊肿的有效手段,而联合进路是伴有眶内独立囊肿及多发巨大囊肿的理想术式。
Objective To explore the treatment of nasal/sinus mucous cyst with unilateral exophthalmos. Methods The clinical data of 17 patients with nasal/sinus mucous cyst causing unilateral exophthalmos who were admitted to our department between 2006 and 2012 were retrospectively reviewed. Results All the 17 patients initially consulted ophthalmologists for exophthalmos or related symptoms such as double vision,ocular dyskinesia and decreased vision. CT and （or） MRI showed frontal sinus was involved in 1 cases, ethmoid sinus in 1 case, both frontal sinus and ethmoid sinus in 11 cases, the frontal sinus, ethmoid sinus and periorbit together in 2 ca- ses,and frontal, ethmoid and sphenoid sinuses in 2 cases （one of them had frontal lobe oppression）. Patients without independent cyst within the orbit underwent nasal endoscopic operation in which the sinus wall was selectively resected. Patients with independent cyst within the orbit were given operation through the combined intranasal and externalnasal route. After operation, the symptoms of all patients such as double vision,ocular dyskinesia and decreased vision were obviously improved. Conclusion The nasal endoscopic surgery is effective in the treatment of nasal sinus mucous cyst with unilateral exophthalmos. Operation through the combination route is the ideal surgical method for patients with independent cyst within the orbit.
出处
《华中科技大学学报（医学版）》
CAS
CSCD
北大核心
2013年第1期83-86,共4页
Acta Medicinae Universitatis Scientiae et Technologiae Huazhong
关键词
鼻窦囊肿
眶内囊肿
鼻窦内窥镜手术
nasal sinus cyst
periorbital cyst
endoscopic sinus surgery
