Kastenbauer E R
Laryngol Rhinol Otol (Stuttg). 1975 Oct;54(10):808-19.
The surgical management of various diseases of the ethmoid-sphenoid region is absolutely indicated in many cases because of the direct neighbourhood and the intimate relationship between a pathological process of these sinuses and a spreading of an infection or a tumor to the adjacent organs such as the orbit, the base of the skull, the dura, the optic nerve and the internal carotid artery. The optic nerve and the carotid artery are intimately related to the lateral wall of the sphenoid sinus and may even bulge into the cavity. In cases of an atypical posterior ethmoid cell we must expect an anomaly of the course of the optic canal with the increased danger of an injury to the optic nerve. The various possibilities of pneumatisation of the ethmoid-sphenoid region are described and illustrated. The diverse methods of the ethmoid-sphenoid operations are demonstrated and compared regarding their effectiveness and operative risk. Details of several iatrogenic injuries of the orbit, the dura or the optic nerve and the management of these lesions are mentioned. The medico-legal situation and the importance of the preoperative informed consent of the patient are discussed.
由于筛窦-蝶窦区域的各种疾病与这些鼻窦的病理过程和感染或肿瘤向眼眶、颅底、硬脑膜、视神经和颈内动脉等邻近器官扩散之间存在直接的毗邻关系和密切联系，在许多情况下，对这些疾病进行外科治疗是绝对必要的。视神经和颈动脉与蝶窦外侧壁密切相关，甚至可能突入窦腔。在非典型后筛窦气房的情况下，我们必须预料到视神经管走行异常，从而增加视神经损伤的风险。本文描述并说明了筛窦-蝶窦区域气化的各种可能性。展示并比较了筛窦-蝶窦手术的不同方法及其有效性和手术风险。文中提到了几例眼眶、硬脑膜或视神经医源性损伤的细节以及这些损伤的处理方法。讨论了医疗法律情况以及患者术前知情同意的重要性。
