Strek P, Zagólski O, Składzień J, Oleś K
Department of Otorhinolaryngology, Collegium Medicum, Jagiellonian University, Kraków, Poland.
B-ENT. 2007;3(3):149-51.
Sphenoid pyoceles with intracranial extension are extremely rare lesions that can mimic tumours and usually cause ophthalmological symptoms. Their infectious nature mandates urgent surgical decompression since pyoceles can cause intracranial and orbital complications.
A 16-year-old male presented with intense headache and dizziness lasting three days. On admission, the patient gave a five-year history of chronic rhinitis, nasal congestion, and progressively worsening headaches. Ophthalmological examination was normal. CT and MR scans disclosed distension of the sphenoid sinus by a pyocele 55 mm in diameter, extending to the presellar region through the eroded cribriform plate. The patient underwent an endoscopic transnasal sphenoethmoidectomy. After surgery he reported improvement in all preoperative symptoms and was asymptomatic at 3-months follow-up.
A huge sphenoid sinus pyocele with intracranial extension may cause no ophthalmological symptoms. It can be safely managed using endoscopic techniques.
伴有颅内扩展的蝶窦脓性囊肿是极为罕见的病变，可酷似肿瘤，且通常会引起眼科症状。因其具有感染性，鉴于脓性囊肿可导致颅内和眼眶并发症，故需紧急进行手术减压。
一名16岁男性出现剧烈头痛和头晕，持续三天。入院时，患者有五年慢性鼻炎、鼻塞病史，且头痛逐渐加重。眼科检查正常。CT和磁共振成像扫描显示蝶窦被一个直径55毫米的脓性囊肿扩张，通过侵蚀的筛板延伸至鞍前区。患者接受了内镜经鼻蝶筛窦切除术。术后他报告所有术前症状均有改善，在3个月随访时无症状。
伴有颅内扩展的巨大蝶窦脓性囊肿可能不引起眼科症状。采用内镜技术可安全地进行治疗。
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