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以头痛或眼部症状为首发症状的孤立性蝶窦疾病

Isolated sphenoid sinus disease presented the primary symptom as headache or ocular disturbance

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【作者】 洪育明梁振源林泼水

【Author】 HONG Yuming LIANG Zhenyuan LIN Poshui(Department of Otolaryngology,the Second Affiliated Hospital of Fujian Medical University,Quanzhou,362000,China)

【机构】 福建医科大学附属第二医院耳鼻咽喉科福建医科大学附属第二医院耳鼻咽喉科 福建泉州362000福建泉州

【摘要】 目的:提高对孤立性蝶窦疾病的认识,以降低其误诊、漏诊的发生率。方法:分析22例孤立性蝶窦疾病患者的临床表现和鼻内镜治疗的优势。结果:12例行鼻内镜蝶窦开放术,7例行鼻外筛窦进路手术,3例行抗感染、激素、神经营养药等治疗,头痛症状全部消失,视力不同程度恢复。眼球运动障碍改善,随访3~6个月,1例症状复发,再次行鼻内镜手术后症状缓解。1例腺样囊性癌术后放疗,随访3年无复发。结论:以头痛和(或)眼部症状为主的孤立性蝶窦疾病,容易造成误诊、漏诊;CT、MRI和鼻内镜的应用,提高了对该病的诊疗水平;鼻内镜手术是治疗孤立性蝶窦疾病的首选。

【Abstract】 Objective:To improve the understanding of the symptoms and signs of isolated sphenoid sinus disease and decrease the occurrence of misdiagnose.Method:The clinical manifestation and the advantage of endoscopic sinus surgery were analyzed in 22 cases of isolated sphenoid sinus disease.Result:Twelve cases had endoscopic sohenoidotomy,7 cases had external ethmoidal sphenoidotomy,3 cases had antibiotic,steroid and neurotrophy therapy.All of the patients were free of headache,improvement in vision and ocular motility after treatment.After 3 to 6 months’follow up,1 case recurred and symptom relieved after endoscopic sinus surgery.1 case adenocystoid carcinoma underwent post operative radiotherapy without recurrence after 3 years follow up.Conclusion:Isolated sphenoid sinus disease presented the primary symptom as headache and/or ocular disturbance is prone to be misdiagnosed,application of CT,MRI and endoscopy improve its diagnosis and treatment standard.Endoscopic sinus surgery is the primary therapy for isolated sphenoid sinus disease.

【关键词】 蝶窦疾病内镜术头痛
【Key words】 Sphenoid sinusDiseasesEndoscopyHeadache
  • 【文献出处】 临床耳鼻咽喉头颈外科杂志 ,Journal of Clinical Otorhinolaryngology Head and Neck Surgery , 编辑部邮箱 ,2007年16期
  • 【分类号】R765.4
  • 【被引频次】7
  • 【下载频次】81
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