Bourgeois P, Fichten A, Louis E, Vincent C, Pertuzon B, Assaker R
Clinique Neurochirurgicale, Hôpital Nord, Chemin des Bourrely, 13915 Marseille Cedex 20, France.
Neurochirurgie. 2002 May;48(2-3 Pt 1):104-8.
Osteomas are the most frequent benign tumors of the paranasal sinuses. They often grow in the frontal sinus near the nasofrontal duct. They remain frequently asymptomatic and they tend to be an incidental finding on radiographic studies. Rarely, they extend out of the sinus limits. Two cases with neuro-ophthalmological complications are reported and discussed. A 19-year-old female presented with a progressive left visual impairment and orbital bone deformity. A CT-scan revealed a large calcified mass in both frontal sinuses, with left intraorbital and frontobasal extension. A 21-year-old man suffered from acute frontoethmoidal sinusitis. Radiological exams revealed a right frontal sinus osteoma with bilateral nasofrontal ducts obstruction. The frontal sinus cavities were filled with a large mucocele with intracranial extension. Both patients were successfully treated using frontobasal craniotomy with complete osteoma and mucocele removal and cranio facial bone reconstruction. Neuro-ophthalmological or intrasinusal complications of osteomas lead to radical treatment. CT-scan and MRI analysis for surgical purpose and strategy are emphased.
骨瘤是鼻窦最常见的良性肿瘤。它们常生长在鼻额管附近的额窦内。通常无症状，往往是在影像学检查时偶然发现。很少会超出鼻窦范围。本文报告并讨论了两例伴有神经眼科并发症的病例。一名19岁女性出现进行性左眼视力损害和眼眶骨畸形。CT扫描显示双侧额窦有一个巨大的钙化肿块，向左侧眶内和额底部延伸。一名21岁男性患有急性额筛窦炎。影像学检查发现右侧额窦骨瘤伴双侧鼻额管阻塞。额窦腔内充满巨大黏液囊肿并向颅内延伸。两名患者均通过额底部开颅手术成功治疗，完整切除骨瘤和黏液囊肿，并进行颅面骨重建。骨瘤的神经眼科或鼻窦内并发症需要进行根治性治疗。强调了用于手术目的和策略的CT扫描和MRI分析。
