经头皮冠状切口及经鼻内镜额筛眶占位性病变切除术的比较研究

目的:探讨经头皮冠状切口径路与经鼻内镜径路额筛眶占位性病变切除术的优缺点及适应证.方法:额筛眶占位性病变患者34例,18例行经鼻内镜额筛眶占位切除术,其中脓囊肿16例,侵袭性血管脂肪瘤1例,骨瘤1例;16例经头皮冠状切口径路手术,其中脓囊肿11例,皮样囊肿3例,表皮样囊肿1例,侵袭性血管脂肪瘤复发1例;术后随访2～4年.结果:18例行经鼻内镜径路患者术后5例仍有头昏或鼻腔胀痛症状,侵袭性血管脂肪瘤1例2年后复发.16例经头皮冠状切口径路手术患者,3例有头昏症状,12例头顶部皮肤麻木,无一例复发.结论;经头皮冠状切口径路与经鼻内镜径路额筛眶占位性病变切除各有其优缺点及适应证,不能盲目夸大其中一种术式的功能.

Comparative study of front-ethmoid-orbital mass resection via transscalp coronary incision and functional endoscopic sinus surgery

Objective:To investigate the advantages and disadvantages between two surgical approaches of transscalp coronary incision(TCI) and functional endoscopic sinus surgery(FESS)by which front-ethmoid-orbital masses being resected.Method:Thirty-four cases of front-ethmoid-orbital mass from 1995-2006 were retrospectively studied, among which lesions of 18 cases resected by FESS, lesions of 16 cases via TCI. The follow-up time varied from 2 to 4 years.Result:Five of 18 cases by FESS had residual dizziness or nasal pain, one case recurred 2 years after the operation. None of TCI cases experienced recurrence, whereas dizziness presented in 3 cases, regional dull sensation of the operative scalp in 12 cases.Conclusion:FESS and TCI approach has its own benefits and shortcomings thus has its indications respectively.