Ichimura K, Ohta Y, Maeda Y I, Sugimura H
Department of Otolaryngology-Head and Neck Surgery, Jichi Medical School, Tochigi, Japan.
Am J Rhinol. 2001 Jul-Aug;15(4):243-7.
Mucoceles of the paranasal sinuses cause progressive distension of the bony walls and induce compressive symptoms. Although rare, cases of massive intracranial extension have occurred. We believe that an endoscopic transnasal approach is the best choice for such huge mucoceles because it is the least invasive and can provide an adequate surgical field of view for wide marsupialization. However, the results of long-term follow-up after endoscopic transnasal surgery have not been reported. This study was designed to evaluate prospectively the postoperative course of patients with intracranially extended mucocele. In the last 5 years, we have operated on four patients with intracranially extended mucocele. Although postopertive scanning is not recommended routinely after surgery for inflammatory disease, we followed up two patients who consented by using magnetic resonance imaging (MRI) along with endoscopy. Dural descent to the original skull base plane necessitated long periods of follow-up, lasting 18 and 5 months, respectively. On the mucocele wall mucosa, which had been smooth during surgery, polyps and granulations developed after surgical drainage and lasted for a considerable time. Although endoscopic transnasal opening of mucocele is a method of choice, we recommend follow-up of such patients for long periods, at least until the frontal skull base dura returns to its original position.
鼻窦黏液囊肿可导致骨壁进行性扩张并引发压迫症状。尽管罕见，但已有黏液囊肿发生大规模颅内扩展的病例。我们认为，对于如此巨大的黏液囊肿，鼻内镜经鼻入路是最佳选择，因为它创伤最小，且能为广泛造袋术提供足够的手术视野。然而，鼻内镜经鼻手术后的长期随访结果尚未见报道。本研究旨在前瞻性评估颅内扩展型黏液囊肿患者的术后病程。在过去5年中，我们为4例颅内扩展型黏液囊肿患者进行了手术。尽管对于炎性疾病手术后一般不建议常规进行术后扫描，但我们对2例同意的患者采用磁共振成像（MRI）和内镜进行了随访。硬脑膜降至原始颅底平面需要分别进行长达18个月和5个月的长期随访。在手术时曾光滑的黏液囊肿壁黏膜上，术后引流后出现了息肉和肉芽，并持续了相当长一段时间。尽管鼻内镜经鼻开放黏液囊肿是一种可选方法，但我们建议对这类患者进行长期随访，至少直到额颅底硬脑膜恢复到其原始位置。
