侵犯眼眶及颅底的鼻窦囊肿的诊断和治疗

目的：总结侵犯眼眶及颅底的鼻窦囊肿的诊断和治疗要点。方法：回顾性研究侵犯眼眶及颅底的30例鼻窦囊肿患者的临床资料。均行CT和MRI检查。所有患者均在鼻内镜下进行手术,其中4例加用了辅助切口。术后均使用激素治疗并常规行鼻内镜复查。结果：所有患者均顺利完成手术,无并发症发生,术中出血50-150ml。术后患者眼球突出、复视、眼球运动障碍、头痛、鼻塞等症状明显改善或痊愈。随访2年以上,除1例患者在术后3个月出现复发外,其他均未复发。结论：鼻内镜手术是治疗鼻窦囊肿的有效方法,术前影像学检查对其诊断、手术难度的估计和器械的准备非常重要。为将囊肿内容物彻底清除及改善外观,合适的辅助切口是必要的。

Diagnosis and treatment of nasal sinus mucoceles invaded the skull base and orbit

Objective：To review the clinical manifestations and management of nasal sinus mucoceles invaded the skull base and orbit.Method：Medical records for 30patients of paranasal sinus mucoceles invaded the skull base and orbit were reviewed retrospectively.CT and MRI were important tools for diagnosing nasal sinus mucocele.The patients received endoscopic surgery to remove mucocele.some of them were operated auxiliary incision.Steroid therapies were given after the operations and routine examination with endoscopy were carried out during follow-up.Result：All cases were successfully performed surgery without complications after the surgeries,or the majority of symptoms.However.vision recovery was observed only in some patients.Recovery of vision depended on the timing of surgery and severity of initial visual loss.Delay treatment can seriously compromise the recovery of vision impairment.Moreover,the patients without light perception before surgery had poor visual recovery even when optic nerve decompressions were performed.Conclusion：Endoscopic surgery has effect on nasal sinus mucocele with visual loss.Because visual recovery depends on prompt diagnosis and surgical intervention,agood understanding of the disease and prompt imaging studies are important.