鼻源性眼眶并发症的鼻内镜手术治疗

目的探讨在鼻内镜下经鼻腔手术治疗鼻源性眼眶并发症的治疗效果。方法16例（17眼）鼻源性眼眶并发症患者在全麻或局麻下分别用鼻内镜经鼻腔行鼻窦内镜手术以及眼眶手术治疗，手术开放了病变的鼻窦，清除了鼻腔、鼻窦内不可逆的病变，对眼眶脓肿彻底引流，行眶内容物减压。术后鼻内镜下鼻腔鼻窦随访、眼科随访0．5a。结果全部患者的病变鼻腔鼻窦以及其所累及眼眶的感染均治愈，术后坚持随访0．5a共15例（1例失访），该15例患者（16眼）术后2～6个月的鼻窦术腔均完全上皮化。视力恢复情况：手术0．5a后6眼视力恢复到正常水平，4眼视力状况不同程度改善，3眼无改善，无视力恶化的病例；术后眼部其他症状：13例患者的眼睑肿胀、突眼等症状基本消失，2例患者术后突眼得到改善。结论在鼻内镜下经鼻对鼻源性眼眶并发症的手术治疗是安全性高、疗效显著、不影响面容、具有明显优点的治疗方式。

Endonasal endoscopic surgery for orbital complication of sinusitis

Objective] To study curative effects and advantages of endoscopic sinus surgery performed on orbital complication of sinusitis. Methods] 16 cases(17 eyes) of chronic sinusitis with orbital complications were performed with the help of endoscopic sinus surgery(ESS) . After a minimum 6-month follow-up after ESS, patients were examined and comparisons of symptoms after surgery were conducted. Result] Acute orbital inflammation of all 16 cases were cured. There were 15 cases with a follow-up of 6 months after surgery, vision of 6 cases completely healed, vision of 4 cases improved, vision of 3 cases of no effect, vision of no cases deteriorated. Orbital swelling and exophthalmos of 11 of 13 cases were almostly disappeared, but exophthalmos of 2 cases gained some relief. Conclusion] Endoscopic sinus surgery, which could significantly increase curative effectiveness and decrease overall surgical complication, is well suitabale for orbital complication of sinusitis.