孤立性蝶窦病变的临床诊断与微创手术

目的　探讨孤立性蝶窦病变的临床诊断及微创手术方法。方法　对收治的 2 8例孤立性蝶窦病变的临床资料进行回顾性分析并文献复习。结果　 2 8例病人术前均经CT或 /和MRI及鼻内镜确诊。术后病理检查证实为蝶窦炎症 6例 (其中伴后鼻孔息肉 4例 )、蝶窦真菌感染 7例、蝶窦黏膜下囊肿 1 0例、蝶窦黏液囊肿 4例(其中 2例侵犯颅底及眼眶、1例至鼻中隔 )、蝶窦内翻性乳头状瘤 1例。 2 8例全部治愈。结论　对临床上有不明原因的头痛、头晕、眼部症状、回缩涕血有必要结合影像学检查及鼻内镜检查 ,以便早期确诊。鼻内镜下鼻腔进路联合切割吸引器对蝶窦病变进行微创手术是治疗孤立性蝶窦病变的一个安全有效的手术方式。

Clinical diagnosis and minimally invasive operation for disease of isolated sphenoid sinus

Objective To study the clinical diagnosis and reasonable minimally invasive operation for the disease of isolated sphenoid sinus. Methods To analyze the clinical data of 28 cases suffering from isolated sphenoid sinus lesions retrospectively and review the correlated documents. Results All 28 cases were preoperativly diagnosed by CT scan, MRI, and intranasal endoscopy. The postoperative pathology showed 6 cases with sphenoid sinusitis (including 4 cases with choanal polyp ), 7 cases with mycosis, 10 cases with submucous cysts, 4 cases with mucoceles (2 cases invaded the skull base, 1 case nasal septum involved), and 1 case with inverted papilloma. All 28 cases were cured. Conclusion Diagnostic nasal endoscopic procedures and imaging techniques are of great value for an early and precise diagnosis to clinical unknown reason of headache, dizziness, and eye symptums etc. Nasal endoscopic surgery combined with minimally invasive operation by incision suction is a safe and effective method for the disease of isolated sphenoid sinus.