不同径路治疗蝶窦病变的体会

目的:提高对蝶窦炎症性疾病及占位性病变的认识,合理选择手术方式。方法:对单纯蝶窦炎症性疾病采用Wigand术式;对伴有筛窦病变者,采用Messerklinger术式;对范围较大的占位性病变,采用扩大鼻侧切开径路。结果:除1例鼻咽癌放疗后复发患者术后2 a死亡,1例视力下降好转外,余19例患者临床症状均消失,随访0.5 a~3a,无复发。结论:CT与MRI检查对蝶窦病变诊断和治疗有很大价值,病变范围、性质、大小是选择手术方法的依据。

To Treat the Sphenoid Sinus Disease with Different Surgical Approach

Objective To recognize precisely inflammatory disease and space occupying lesion of sphenoid sinus,to select reasonable operative treatment.Methods Used endoscopic sinus surgery,simple sphenoid sinus inflammatory used wigan surgical treatment,sphenoid sinus infammatory disease with ethnoid sinusitis used messerklinger surgical treatment.Big sphere space occupying lesion of sphenoid sinus used enlarged lateral rhintomy.Results The symptoms of 19 cases were disappeared and no relapse for 6-36 months follow-up except 1 relapsing nasopharyngeal carcinoma casedied 2 years later after operation and 1 hypopsia case improved.Conclusion Computer technology(CT) and magnetic resonance imaging(MRI) was value to diagnosis and treatment of sphenoid sinus disease,it was reasonable to adopt different operative approach based on pathologic change and sphere.