Strek Pawel, Zagólski Olaf, Składzień Jacek, Oleś Krzysztof, Konior Marcin, Hydzik-Sobocińska Karolina, Głowacki Roman
Katedra i Klinika Otolaryngologii Collegium Medicum UJ w Krakowie.
Otolaryngol Pol. 2007;61(3):260-4. doi: 10.1016/S0030-6657(07)70423-7.
Osteomas are relatively common, benign, slow-growing, often asymptomatic neoplasms of the paranasal sinuses, occurring mainly in frontal and ethmoid sinuses. Surgical removal is done if they extend beyond the boundaries of the sinus, keep enlarging, are localised in the region adjacent to the nasofrontal duct, or if signs of chronic sinusitis are present and, irrespective of their size, in symptomatic tumours. Progressive headaches and chronic inflammation of the adjacent mucous membrane are most common symptoms. Endoscopic surgery plays an important role in management of ethmoid, sphenoid and frontal osteomas. Aim. The aim of the paper was to report own experience in endoscopic treatment of patients with osteomas of the paranasal sinuses. Material and methods. 6 patients with osteomas of paranasal sinuses were included in the group, mean age 36 years (range 15-52). Most common involvement was ethmoid cells (3). There were also patients with frontal, maxillary and sphenoid osteoma. All tumours were removed under endoscopic giudance. Frontoethmoidectomy was performed to remove ethmoid and frontal osteomas. Antrotomy was used in case of maxillary involvement and sphenoethmoidectomy in the patient with sphenoid sinus osteoma. Sphenoid sinus was approached through its anterior wall with a Stammberger punch. All the tumours were removed using fine forceps. Results. No post-operative complications were observed. No recurrences were noted. All patients remain asymptomatic. Conclusions. Resection of small and medium size osteomas of the paranasal sinuses can be safely and radically performed using endoscopic techniques. It allows their radical resection and very good cosmetic effects.
骨瘤相对常见,是鼻窦的良性、生长缓慢、通常无症状的肿瘤,主要发生在额窦和筛窦。如果骨瘤超出鼻窦边界、持续增大、位于鼻额管附近区域,或者存在慢性鼻窦炎体征且无论大小,对于有症状的肿瘤,均需进行手术切除。进行性头痛和相邻黏膜的慢性炎症是最常见的症状。内镜手术在筛窦、蝶窦和额窦骨瘤的治疗中发挥着重要作用。目的。本文旨在报告鼻窦骨瘤患者内镜治疗的自身经验。材料与方法。该组纳入6例鼻窦骨瘤患者,平均年龄36岁(范围15 - 52岁)。最常见受累部位是筛窦气房(3例)。也有额窦、上颌窦和蝶窦骨瘤患者。所有肿瘤均在内镜引导下切除。行额筛窦切除术以切除筛窦和额窦骨瘤。上颌窦受累时采用上颌窦切开术,蝶窦骨瘤患者采用蝶筛窦切除术。用施坦伯格咬骨钳经蝶窦前壁进入蝶窦。所有肿瘤均用精细镊子切除。结果。未观察到术后并发症。未发现复发情况。所有患者均无症状。结论。使用内镜技术可安全、彻底地切除鼻窦中小尺寸骨瘤。它能实现骨瘤的根治性切除并取得很好的美容效果。