Babiński Dariusz, Skorek Andrzej, Stankiewicz Czesław
Katedra i Klinika Chorób Uszu, Nosa, Gardła i Krtani AM w Gdańsku.
Otolaryngol Pol. 2006;60(6):929-33.
We discuss 3 cases with chronic maxillary atelectasis presenting as enophthalmos without any particular evidences of sinus pathology.
We report clinical features and imaging data of sinus atelectasis in 2 men and 1 woman, 20-39 years old. Only 1 patient complained of diplopia, in 2 patients we found allergic rhinitis, in 2 cases septal deviation. Hertel enophthalmometry demonstrated enophthalmos 1-4 mm. Evidences have lasted for 2-6 months. CT scans revealed unilateral complete antral opacification, inward bowing of the antral medial and postero-lateral walls and collapse of orbital floor.
Three patients with enophthalmos and asymptomatic maxillary sinus disease were identified. All patients underwent successful functional endoscopic sinus surgery with endoscopic maxillary antrostomy and in one case anterior ethmoidectomy. Additionally septoplasty was performed in two cases. We did not need to repair orbital floor in any case. Patient with diplopia achieved spontaneous return of orbital floor to almost normal position with enophthalmos -1 mm and all three were asymptomatic. Intrasinus manometry was performed in one case and confirmed the presence of negative pressure (-2,8 cm H2O).
Chronic maxillary atelectasis presenting as enophthalmos is a rare evidence and sinus component of the disease mostly remains asymptomatic. The most effective treatment is endoscopic maxillary antrostomy.
我们讨论3例慢性上颌窦肺不张表现为眼球内陷且无鼻窦病变特殊证据的病例。
我们报告了2名男性和1名女性（年龄20 - 39岁）鼻窦肺不张的临床特征和影像学数据。仅1例患者主诉复视，2例患者有过敏性鼻炎，2例有鼻中隔偏曲。Hertel眼球突出计测量显示眼球内陷1 - 4毫米。这些症状持续了2 - 6个月。CT扫描显示单侧上颌窦完全混浊，上颌窦内侧壁和后外侧壁向内凹陷以及眶底塌陷。
确诊3例眼球内陷且上颌窦疾病无症状的患者。所有患者均成功接受了功能性鼻内镜鼻窦手术，包括内镜下上颌窦造瘘术，1例还进行了前筛窦切除术。另外2例进行了鼻中隔成形术。所有病例均无需修复眶底。复视患者的眶底自发恢复到几乎正常位置，眼球内陷-1毫米，3例患者均无症状。1例患者进行了窦内测压，证实存在负压（-2.8厘米水柱）。
以眼球内陷为表现的慢性上颌窦肺不张是一种罕见情况，该疾病的鼻窦部分大多无症状。最有效的治疗方法是内镜下上颌窦造瘘术。
