[鼻窦黏液囊肿]

[Mucoceles of the paranasal sinuses].

作者信息

Kuczkowski Jerzy, Narozny Waldemar, Stankiewicz Czesław, Izycka-Swieszewska Ewa, Skrzypczak Wojciech, Kowalska Ewa, Plichta Lukasz

机构信息

Katedra i Klinika Chorób Uszu, Nosa, Gardła i Krtani AM w Gdańsku.

出版信息

Otolaryngol Pol. 2007;61(5):680-6. doi: 10.1016/S0030-6657(07)70506-1.

DOI:10.1016/S0030-6657(07)70506-1

PMID:18552000

Abstract

INTRODUCTION

Paranasal sinus mucocoele is a benign pseudocystic lesion, which may originate from any sinus cavities when their natural ostia are blocked. Raising mucocoele in frontal, ethmoid or sphenoid sinus causes headache, disorders of eye mobility and deformities of forehead or orbit.

AIM OF THIS STUDY

was clinical analysis of treatment results taking into consideration the method of surgical treatment.

MATERIAL AND METHOD

Presented material consists of 42 patients (39 adults and 3 children), 22 females and 20 males, in the age from 8 to 76 treated at Department of Otolaryngology of Medical University of Gdansk in the years from 1995 to 2005 for paranasal sinuses mucocoele.

RESULTS

Fronto-ethomidal mucocoele was found in 22 (52.4%) patients, ethmoidal--in 10 (23.8%), frontal--in 4 (9.5%), spheno-ethmoidal--in 4 (9.5%) and maxillar in 2 (4.8%) patients. 14 (33.3%) cases were primary and 28 (66.7%) secondary of mucocoeles. The most frequent symptoms of frontal or ethmoidal mucocoele were: headache, lacrimation, deformity of orbit, blepharoedema, and diplopia. Sphenoethmoidal and maxillar mucocoele caused mostly nose obstruction and severe headache. Destruction of sinuses and orbital bony wall was found in 16 patients (38.1%), and in 9 of them (21.4%) there were in medial wall of orbit, in 3 (7.1%)--in inferior wall of frontal sinus, in 3 (7.1%)--in anterior wall of frontal sinus, and in 1 (2.3%) in anterior wall of maxillary sinus. In 3 patients (97.1%) with fronto-ethmoidal mucocoele as the consequence of disease the development of empyema was observed. Endoscopic intranasal treatment was applied in 9 patients (21.4%) with fronto-ethmoidal, spheno-ethmoidal and maxillar mucocoele. Complete recovery was observed in 30 (71.4%) patients, recurrence was noted in 12 (28.6%) and these patients were operated from extranasal approach.

CONCLUSIONS

Paranasal sinuses mucocoele is found when natural ostia of sinuses are blocked after prior operation. They cause destruction of bony walls of sinuses. Extranasal approach is an optimal method of treatment in extended mucocoele and their complications.

摘要

引言

鼻窦黏液囊肿是一种良性假性囊肿性病变，当其天然开口被阻塞时，可起源于任何鼻窦腔。额窦、筛窦或蝶窦的黏液囊肿可引起头痛、眼球活动障碍以及前额或眼眶畸形。

本研究目的

考虑手术治疗方法，对治疗结果进行临床分析。

材料与方法

所呈现的材料包括42例患者（39例成人和3例儿童），其中女性22例，男性20例，年龄在8至76岁之间，于1995年至2005年在格但斯克医科大学耳鼻喉科接受鼻窦黏液囊肿治疗。

结果

22例（52.4%）患者为额筛窦黏液囊肿，10例（23.8%）为筛窦黏液囊肿，4例（9.5%）为额窦黏液囊肿，4例（9.5%）为蝶筛窦黏液囊肿，2例（4.8%）为上颌窦黏液囊肿。14例（33.3%）病例为原发性黏液囊肿，28例（66.7%）为继发性黏液囊肿。额窦或筛窦黏液囊肿最常见的症状为：头痛、流泪、眼眶畸形、眼睑水肿和复视。蝶筛窦和上颌窦黏液囊肿主要引起鼻塞和严重头痛。16例患者（38.1%）发现鼻窦和眼眶骨壁破坏，其中9例（21.4%）位于眼眶内侧壁，3例（7.1%）位于额窦下壁，3例（7.1%）位于额窦前壁，1例（2.3%）位于上颌窦前壁。3例（7.1%）额筛窦黏液囊肿患者因疾病发展出现了脓胸。9例（21.4%）额筛窦、蝶筛窦和上颌窦黏液囊肿患者采用了鼻内镜下鼻内治疗。30例（71.4%）患者完全康复，12例（28.6%）复发，这些复发患者接受了鼻外入路手术。