蝶窦病变25例临床分析

目的：探讨蝶窦病变的诊断和治疗，以降低本病的误诊和漏诊率。方法：回顾性分析1996～2005年25例蝶窦病变患者的临床资料，并复习相关文献；25例均行鼻内镜下蝶窦手术。结果：25例患者主要以头痛和（或）眼部症状为首发症状，其中21例在确诊前经过首诊科室的相关检查和对症治疗。全部患者经CT或MRI检查及术后病理检查确诊；24例术后所有症状先后缓解或消失，1例无明显变化。结论：蝶窦病变易误诊、漏诊。诊断本病有赖于CT和MRI检查，CT三维重建可为术前评估提供多方位空间信息，鼻内镜下蝶窦手术使本病的治疗更安全、有效。

Clinical analysis of isolated sphenoid disease first manifesting headache and/or ophthalmic symptoms

Objective:To improve the diagnosis and treatment of isolated sphenoid disease first manifesting headache and/or eye symptoms.Method:The clinical data of 25 cases suffering from isolated sphenoid disease first manifesting headache and/or eye symptoms from 1996 to 2005 were analyzed retrospectively, and the correlated documents were reviewed.Result:In this group of the 25 patients, 21 failed to be diagnosed at the first time of medical consultation. The diagnosis confirmed by CT or MRI and pathology included 7 cases with isolated sphenoiditis, 4 with mycosis, 3 with sphenoid cysts,6 with purulent sphenoid cysts,2 with polyps and sphenoiditis,1 with foreign body, 1 with craniopharyngioma,and 1 with oncocytoma.All of the patients underwent endoscopic sphenoid surgery. The symptoms of 24 cases of the patients were improved or disappeared after the operations.Conclusion:This isolated sphenoid diseases were easily misdiagnosed. The diagnosis depends on CT or MRI and nasal endoscopy. CT by three-dimensional reconstruction can provide more special and precise information.Endoscopic sinus surgery is effective and safe technique for the treatment of the disease.