上颌窦髓外浆细胞瘤1例

1临床资料患者,男,42岁。因左眼溢泪6个月,左侧鼻塞伴左侧头痛1个月于2011年1月人院。患者6个月前无明显诱因出现左眼溢泪及左侧鼻塞,伴阵发性头痛,头痛无规律,以左侧前额部为重,无鼻涕及涕中带血,无视物模糊及复视。曾于外院多次诊断为泪囊炎,全身应用抗生素及眼药水滴眼治疗,溢泪无好转。     

筛窦上颌窦肌上皮癌1例

肌上皮癌(myoepithelial carcinoma)是一种少见恶性肿瘤,主要位于腮腺,其次位于腭部和其它涎腺,少数位于上唇、舌根,而发生在鼻窦十分罕见[1~3]。我科于2001年8月收治1例筛窦上颌窦肌上皮癌,现报道如下。1 临床资料患者,女,37岁。因“左眼溢泪,视力下降3月,左鼻塞半月”入院。查体:左内眦近鼻根处,有一质地较硬固定肿块,约3cm×2cm大小,触诊肿块呈结节状     

鼻腔和筛窦上皮样血管肉瘤侵犯颅内致死亡一例

患者男,52岁,因右侧鼻腔出血半年,加重伴鼻塞、头痛1个月于2008年6月入院.患者伴右眼溢泪,右面颊麻木感,无复视、视力下降,无发热,于当地医院抗炎对症治疗后无好转.     

鼻内镜下泪囊鼻腔造口术

慢性泪囊炎的治疗方法传统为泪囊鼻腔吻合术，颜面部遗留瘢痕。手术操作烦杂，时间长。我院自１９９６年２月起开展鼻内镜下泪囊鼻腔造口术，效果满意，报告如下。1 临床资料与方法1．１ 临床资料于门诊选择慢性泪囊炎成年人患者１５只眼，女９只，男6只；所有病例均为患眼溢泪、溢脓；病史３年～１２年不等；经药物系统治疗、冲洗及探通无效，无严重重要器官功能障碍及出血性疾病患者。1．２ 手术方法常规体位，消毒，２％地卡因鼻腔粘膜表面麻醉，１％利多卡因作鼻丘粘膜下浸润麻醉。如有鼻中隔弯曲、中鼻甲前端大等作相应处理。鼻外使用…     

误诊为泪囊炎的上颌窦癌1例

1临床资料 患者,男,25岁。因左眼溢泪、流脓20天,于2000年1月以左眼“慢性泪囊炎”收治入院。既往双侧鼻腔通气好,无脓血性涕,无鼻面部肿痛。查体:左眼无突眼,视力正常,无复视。挤压左眼泪囊有脓性分泌物流出,泪道冲洗有脓性分泌物自泪小点返流。鼻甲无肿大,中鼻道未见脓性分泌物及新生物,面颈部淋巴结未触及。三天后在局麻下行左眼泪囊鼻腔吻合术,术中见泪囊扩张,泪囊内壁光滑无肿物,鼻粘膜无增生肥厚,未见周边骨质破坏等。术后泪道冲洗通畅,“泪囊炎”     

经上颌窦治疗鼻泪管狭窄

以往鼻泪管狭窄手术方法有:(1)泪囊鼻腔吻合术,可分鼻外法、鼻内法及经上颌窦法。鼻外法是从眼内眦部切开处理泪囊;鼻内法是削除鼻丘部骨壁向上,处理泪囊和鼻泪管,但手术需时较长,术野小,开窗翻转粘膜、固定缝合等均有一定困难。(2)泪囊上颌窦吻合术,是打开上颌窦而不直接与鼻腔相通,本法适用于鼻窦无炎症者。(3)泪囊筛窦吻合术,是在眼内眦部作切口,露出泪囊,纵行切开其后壁,除去后壁部骨质,使之与前组筛房相通,此法去除骨质少,方法简单。作者们对上述方法加以改进,取上颌窦经路,为3例泪囊炎-鼻泪管狭窄患者(其中2例有鼻窦炎)作了手术,均获治愈。手术系     

经鼻内镜泪囊功能造口并“T”形引流管植入术治疗泪囊炎52例报告

慢性泪囊炎是临床上的常见病、多发病,可发生在不同年龄,以溢泪、溢脓为主要症状以手术治疗为主,手术方法分鼻外法及鼻内法。2010年前我院主要采用鼻外法手术,自2010年以来开展经鼻内镜泪囊功能造口并"T"形引流管植入术52例,取得较好疗效,现报告如下。1资料与方法1.1临床资料2010-2011年我院共收治52例(54眼)慢性泪囊炎患者,男16例,女36例;年龄18～72岁;病     

右鼻腔、上颌窦、筛窦、眶内平滑肌肉瘤1例

患者，女，２４岁。因持续性右鼻塞、右眼溢泪５个月入院。患者５个月前右鼻塞，呈持续性加重，偶有血性涕，伴右眼溢泪，视物模糊。体检：神志清，右侧鼻翼较左侧隆起，右侧中鼻道见红色肿物突出，向下压迫下鼻甲，肿物质软，表面光滑，易出血，右上颌窦区有压痛。肿物活...     

上颌窦、筛窦及额窦平滑肌瘤一例

患者,女,57岁。因双鼻塞30余年,右内眦部肿胀5周于1989年10月5日入院。患者30年前始感鼻塞、喷嚏多、流清涕。鼻塞逐年加重,嗅觉减退。近两年来需张口呼吸,记忆力减退。5周前感右眼内眦部有肿块向外突出,但不痛,无溢泪及复视,亦无涕中带血。体检:一般情况可,心肺正常。右眼内眦处肿块有囊性感,双鼻腔内充满荔枝样新生物。X线柯氏位检查提示右眼眶内壁骨质改变,筛窦占位性病变可能。于10月9日行双鼻息肉摘除术。术后为病理证实。行CT检查,提示右侧前筛窦占位     

鼻内镜下鼻腔泪囊吻合术38例临床效果分析

目的 研究鼻内镜下鼻腔泪囊吻合术的临床效果,分析手术无效的原因。方法 对38例(38眼)慢性泪囊炎患者施行鼻内镜下鼻腔泪囊吻合术,观察术后泪道通畅程度, 分析手术无效原因。结果 患者手术过程均顺利,术后随诊 6个月,治愈36例、36眼占94.7% , 无效2例、2眼占5.3%。无效者1例为鼻息肉患者术后息肉复发,造口处反复有肉芽组织增生,经多次局部处理,终至闭锁,患者拒绝再次手术;1例为颌面部复合型骨折致慢性泪囊炎,术后溢泪,但无再溢脓。结论 鼻内镜下鼻腔泪囊吻合术具有方法简便、出血少、无面部瘢痕、手术视野清晰、术中损伤小、患者痛苦轻、并发症少等优点。     

以眼部症状为首发的额、筛囊肿16例临床分析

目的：探讨以眼部症状为首发的额、筛囊肿的诊断及经鼻内镜手术治疗的疗效。方法：回顾性分析2006—02—2008—03期间收治的16例额、筛囊肿患者的临床资料。结果：16例患者中鼻窦MRI及CT检查诊断符合率为100％。14例患者经鼻内镜手术治疗后眼部症状消失,2例好转。随访3～6年,至今均无复发,疗效满意。结论：鼻窦与眼眶关系密切,鼻窦病变患者常首诊于眼科;MRI及CT检查结果对确诊很有价值。对于以眼部症状为主症的额、筛囊肿患者应及早确诊;鼻内镜手术治疗是安全有效的首选治疗方法。     

孤立性蝶窦疾病的诊断及其鼻内镜手术治疗

目的：探讨孤立性蝶窦疾病的临床特点、影像学特征和鼻内镜手术的疗效。方法：38例孤立性蝶窦疾病患者,35例行鼻窦CT（其中5例同时行MRI）,3例行单纯鼻窦MRI,1例行脑池CT造影。所有患者均行鼻内镜下蝶窦开放术,其中有33例采用经鼻腔嗅裂径路,5例采用经前筛一后筛径路（即Messerklinger技术）。结果：术后随访6个月以上,34例病情完全控制,4例部分控制。术中和术后均未出现严重并发症。结论：孤立性蝶窦疾病临床症状不典型,无特异性,鼻部检查多无阳性体征,仅有以头痛为主诉的神经系统症状,早期常难以确诊。鼻窦CT和MRI是诊断孤立性蝶窦炎的最佳手段,而鼻内镜手术则是治疗该病的首选方法。     

Synovial sarcoma of the ethmoid sinus

IntroductionSynovial sarcoma is a malignant mesenchymal tumour typically occurring in the extremities. Its occurrence in the head and neck region, particularly in the paranasal sinuses is extremely rare.Case reportHere, we report a case of primary synovial sarcoma of the ethmoid sinus in a 36-year-old female and review the literature of synovial sarcomas arising from the ethmoid sinus. Histopathology was essential in confirming the diagnosis. The patient underwent endoscopic excision of the tumour followed by postoperative radiotherapy.DiscussionAs per our knowledge, only 2 cases of ethmoid sinus synovial sarcoma have been reported in the English literature till date. Although synovial sarcomas rarely involve the paranasal sinuses, they should be included in the differential diagnosis of paranasal sinus tumours. The accepted treatment modality is wide local excision followed by post operative radiotherapy.     

筛窦骨瘤(附7例报告)

报告７例筛窦骨瘤,男５例,女２例,７例行Ｘ线检查,６例行ＣＴ检查,１例行ＭＲＩ检查,均为筛窦内高密度阴影,病理检查４例为坚质型骨瘤,１例为松质型,２例混合型,７例病人均行手术治疗,３例经眶上眉弓切口切除,３例行经典鼻侧切开术,１例经颅内途径切除。并对本病的病因、病理、诊断与治疗进行了讨论。     

Primary osteogenic sarcoma of the ethmoid sinus: a case report

Primary osteogenic sarcoma arising from the ethmoid sinus is an extremely rare condition. We report herein a 50-year-old female presenting with lacrimation. Computed tomography (CT) scan showed tumor calcification, which is a common feature of osteogenic sarcoma. Exploratory ethmoidectomy was performed, and histological examination confirmed the diagnosis of osteogenic sarcoma. Radiation therapy and chemotherapy failed to reduce the tumor size. The patient was finally treated by anterior craniofacial resection and orbital exenteration. Although primary osteogenic sarcoma of the ethmoid sinus is uncommon, the authors emphasize that osteogenic sarcoma should be suspected when tumor calcification was observed on CT scan and that adequate surgical resection with negative surgical margins remains the mainstay of treatment of this lesion.     

Sinonasal fibrosarcoma: a case report

Sinonasal fibrosarcoma (SFS) is an infrequent malignant neoplasm. It usually presents as other sarcomas in this region, with nasal obstruction and epistaxis. The final diagnosis is based on the histopathology and immunohistochemistry. We report the case of a 58-year-old man with an 8-month history of left proptosis, recurrent epistaxis and nasal obstruction. Nasal endoscopy confirmed a left nasal neoplasia. CT and MRI showed the extension of the neoplasia, occupying the left nasal fossa and ethmoid sinuses, and eroding the medial wall of the orbit. Complete removal was achieved through endoscopic sinus surgery, preserving the orbit. SFS was found on histopathologic examination. After 4 years of follow-up, nasal endoscopy, CT and MRI imaging show no sign of recurrence.     

Ethmomaxillary sinus

Ethmomaxillary sinus is a variation of the posterior ethmoid cells. It is formed by the extension of the posterior ethmoid cells into the maxillary sinus and drains into superior nasal meatus. It is incidentally seen on paranasal sinus computerized tomography (CT) scans. Its prevalence has been reported as 0.7 and 2% in two studies. In this study, paranasal CT scans of 466 patients were investigated for the presence of ethmomaxillary sinus. The patients had paranasal CT with the preliminary diagnoses of septal deviation, chronic inflammatory paranasal sinus disease and nasal turbinate disorders. The ethmomaxillary sinus was present in nine of those patients (1.93%). It was septated in one of them. The CTs were further investigated for other anatomical variations and co-existent mucosal disease of the paranasal sinuses.     

Sturz auf das Gesicht bei 2-j?hrigem Kind

Foreign bodies in the face are often not discovered at first sight. If there is reasonable suspicion caused by anamnesis or by clinical examination of a facial foreign body, a CT scan should be done. However, consideration should be given to wooden foreign bodies, which may appear different depending on the water content and are therefore often misinterpreted. Wooden foreign bodies should be extracted immediately to avoid severe complications. After surgery, regular controls of the wound should be carried out to immediately recognize and treat infection of the lesion.     

鼻内镜下切除筛窦骨瘤13例

目的:报告鼻内镜下切除筛窦骨瘤13例(14侧),并探讨相关的技术方法.方法:采用回顾性研究方法,并复习文献进行讨论.13例筛窦骨瘤患者,7例(8侧)术前CT示骨瘤未附着在纸样板、前颅底,在鼻内镜下解剖骨瘤与周围的联系后切除;4例术前CT示骨瘤附着在纸样板、2例术前CT示骨瘤附着在前颅底,在鼻内镜下解剖、暴露骨瘤后用电钻磨除.结果:13例(14侧)筛窦骨瘤在鼻内镜下完整切除,无眶内和颅内并发症,所有患者术腔在6～8周内上皮化.结论:术前冠位加轴位CT扫描能较完整评价骨瘤与筛窦各壁的关系,为手术方法和器械的选择提供有益的帮助;鼻内镜下配合适宜的手术器械,如电钻等切除筛窦骨瘤,无面部瘢痕、创伤小,是经鼻内途径切除筛窦骨瘤的理想选择.     

16排多层螺旋CT对国人后筛的观测研究

目的：探讨多层螺旋CT扫描对国人后筛解剖特征的研究价值,为鼻内镜相关手术提供影像解剖依据。方法：对100例行椎动脉造影者进行头部螺旋CT横轴位扫描,通过多平面重组获得冠、矢状面图像,对后筛进行动态观测。结果：根据后筛与蝶窦的相邻关系,将后筛分为蝶前型后筛和蝶上型后筛;根据后筛与视神经管的毗邻位置关系分为管前型、半管相邻型和全管相邻型;根据后筛内视神经管突出程度,即筛窦气房占视神经管全程的比例,以10％和50％为界,将两者关系分为压迹型、半管型和管型。视神经结节发生率为20％。结论：多层螺旋CT扫描及多平面重建技术可对筛窦及毗邻作出更准确的判断。对临床手术治疗具有重要的指导意义。