Wang Tsung-Jen, Liao Shu-Lang, Jou Jeih-Ren, Lin Luke Long-Kaung
Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan.
Jpn J Ophthalmol. 2005 May-Jun;49(3):239-45. doi: 10.1007/s10384-004-0174-8.
To report the clinical features of orbital mucoceles and discuss the role of ophthalmologists in the management of patients with orbital mucoceles.
A retrospective chart review was performed of all patients with orbital mucoceles treated at the National Taiwan University Hospital from 1990 through 2002. The basic profiles, clinical features, and the management of the patients with orbital mucoceles were recorded and analyzed.
The records of a total of 15 patients (aged 22 to 76, mean 45.5 years) with orbital mucoceles were selected for this study. The initial presentations included proptosis in ten patients (66.7%), diplopia in five (33.3%), ocular movement limitation in four (26.7%), periorbital pain in four (26.7%), palpable mass lesion in four (26.7%), ptosis in three (20.0%), decreased visual acuity in three (20.0%), headache in two (13.3%), and pupil abnormality with relative afferent papillary defect in one (6.67%). Of the 15 patients, the origins of the orbital mucocele were in the frontoethmoidal sinus in six (40.0%), the ethmoidal sinus in three (20.0%), the frontal sinus in three (20.0%), the maxillary sinus in one (6.7%), and the sphenoidal sinus in two (13.3%). The transcaruncular approach for the management of orbital mucoceles was performed in eight cases, the Lynch approach in three cases, the transforniceal approach in two cases, and functional endoscopic sinus surgery in one case. After surgery, no recurrence was noted.
The frontoethmoidal sinus was the commonest origin of an orbital mucocele, and proptosis was the most frequent sign in patients with an orbital mucocele. All cases showed a favorable response to surgical intervention, and the transcaruncular approach may offer a good surgical option for the management of orbital mucoceles, especially for ophthalmologists.
报告眼眶黏液囊肿的临床特征，并探讨眼科医生在眼眶黏液囊肿患者管理中的作用。
对1990年至2002年在台湾大学医院接受治疗的所有眼眶黏液囊肿患者进行回顾性病历审查。记录并分析眼眶黏液囊肿患者的基本资料、临床特征及治疗情况。
本研究共选取15例眼眶黏液囊肿患者（年龄22至76岁，平均45.5岁）。初始表现包括眼球突出10例（66.7%）、复视5例（33.3%）、眼球运动受限4例（26.7%）、眶周疼痛4例（26.7%）、可触及肿块病变4例（26.7%）、上睑下垂3例（20.0%）、视力下降3例（20.0%）、头痛2例（13.3%）、瞳孔异常伴相对传入性瞳孔障碍1例（6.67%）。15例患者中，眼眶黏液囊肿的起源位于额筛窦6例（40.0%）、筛窦3例（20.0%）、额窦3例（20.0%）、上颌窦1例（6.7%）、蝶窦2例（13.3%）。8例行经泪阜入路治疗眼眶黏液囊肿，3例行Lynch入路，2例行经穹窿入路，1例行功能性鼻内镜鼻窦手术。术后未见复发。
额筛窦是眼眶黏液囊肿最常见的起源部位，眼球突出是眼眶黏液囊肿患者最常见的体征。所有病例手术干预效果良好，经泪阜入路可能为眼眶黏液囊肿的治疗提供良好的手术选择，尤其对眼科医生而言。
