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[蝶窦切开术——孤立性蝶窦疾病患者的治疗]

[Sphenoidotomy--the treatment of patients with isolated sphenoid sinus diseases].

作者信息

Kozłowski Zbigniew, Mazerant Marcin, Skóra Wojciech, Dabrowska Katarzyna

机构信息

Klinika Laryngologii Onkologicznej UM w Łodzi, Uniwersytecki Szpital Kliniczny nr 1 im. N. Barlickiego.

出版信息

Otolaryngol Pol. 2008;62(5):582-6. doi: 10.1016/S0030-6657(08)70319-6.

Abstract

INTRODUCTION

The standart terms and definitions for paranasal sinuses operations were published in 2005 by Simmen and Jones. Sphenoidotomy is a surgical procedure when the natural ostium of sphenoid sinus is enlarged in varying degrees. Microscopic, endoscopic or ballon-assisted endoscopic sphenoidotomy are performed in endonasal sinus surgery and endonasal neurosurgery. This approach is considered for cases of isolated lesions of the sphenoid sinus, the sella lesions, the cerebrospinal fluid leaks into the sphenoid sinus and also for the treatment pathological conditions in the skull base. Isolated lesions of the sphenoid sinus are very rare with uncharacteristic symptoms. Headache is the most common. Vision disturbances occur occasionally. Endoscope assisted physical examination and CT scans of paranasal sinuses are necessary to make a diagnose.

MATERIAL AND METHODS

5 patients suffering from the isolated sphenoid sinus lesion were diagnosed and treated at the Otolaryngology Department of Medical University of Lodz in 2007. Clinical data of these patients were analysed retrospectively. 4 underwent the transnasal endoscopic sphenoidotomy. There were 3 patients with chronic sinusitis, 1 with pyocele. 1 patient didn't agree for the operation.

RESULTS

All treated patients noted improvement in the preoperative symptoms. There were no complications during and after the operation.

CONCLUSIONS

Endoscopic sphenoidotomy is an effective and safe method of treatment of the isolated sphenoid sinus diseases. Nasal endoscopy and CT imaging are necessary for a precise diagnosis and treatment decision.

摘要

引言

2005年,西門和瓊斯發佈了鼻旁竇手術的標準術語和定義。蝶竇開放術是一種外科手術,即蝶竇自然開口被不同程度地擴大。在鼻內竇手術和鼻內神經外科手術中可進行顯微鏡下、內窺鏡下或球囊輔助內窺鏡下蝶竇開放術。對於孤立性蝶竇病變、鞍區病變、腦脊液漏入蝶竇以及治療顱底病變的病例,可考慮採用這種方法。孤立性蝶竇病變非常罕見,症狀不典型。頭痛是最常見的症狀。視力障礙偶爾發生。需要進行內窺鏡輔助體格檢查和鼻旁竇CT掃描以做出診斷。

材料與方法

2007年,羅茲醫科大學耳鼻喉科診斷並治療了5例孤立性蝶竇病變患者。對這些患者的臨床資料進行了回顧性分析。4例接受了經鼻內窺鏡蝶竇開放術。其中3例患有慢性鼻竇炎,1例患有膿腫。1例患者不同意手術。

結果

所有接受治療的患者術前症狀均有改善。手術中和手術後均無併發症。

結論

內窺鏡蝶竇開放術是治療孤立性蝶竇疾病的有效且安全的方法。鼻內窺鏡檢查和CT成像對於準確診斷和治療決策是必要的。

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