以头痛或眼部症状为首发症状的孤立性蝶窦疾病

目的：提高对孤立性蝶窦疾病的认识,以降低其误诊、漏诊的发生率。方法：分析22例孤立性蝶窦疾病患者的临床表现和鼻内镜治疗的优势。结果：12例行鼻内镜蝶窦开放术,7例行鼻外筛窦进路手术,3例行抗感染、激素、神经营养药等治疗,头痛症状全部消失,视力不同程度恢复。眼球运动障碍改善,随访3-6个月,1例症状复发,再次行鼻内镜手术后症状缓解。1例腺样囊性癌术后放疗,随访3年无复发。结论：以头痛和（或）眼部症状为主的孤立性蝶窦疾病,容易造成误诊、漏诊;CT、MRI和鼻内镜的应用,提高了对该病的诊疗水平;鼻内镜手术是治疗孤立性蝶窦疾病的首选。

Isolated sphenoid sinus disease presented the primary symptom as headache or ocular disturbance

Objective:To improve the understanding of the symptoms and signs of isolated sphenoid sinus disease and decrease the occurrence of misdiagnose.Method:The clinical manifestation and the advantage of endoscopic sinus surgery were analyzed in 22 cases of isolated sphenoid sinus disease.Result:Twelve cases had endoscopic sohenoidotomy,7 cases had external ethmoidal sphenoidotomy,3 cases had antibiotic,steroid and neurotrophy therapy.All of the patients were free of headache,improvement in vision and ocular motility after treatment.After 3 to 6 months'follow up,1 case recurred and symptom relieved after endoscopic sinus surgery.1 case adenocystoid carcinoma underwent post operative radiotherapy without recurrence after 3 years follow up.Conclusion:Isolated sphenoid sinus disease presented the primary symptom as headache and/or ocular disturbance is prone to be misdiagnosed,application of CT,MRI and endoscopy improve its diagnosis and treatment standard.Endoscopic sinus surgery is the primary therapy for isolated sphenoid sinus disease.