Majithia A, Liyanage S H, Hewitt R, Grant W E
Department of Otolaryngology, Charing Cross Hospital, London, UK.
J Laryngol Otol. 2010 Dec;124(12):1309-13. doi: 10.1017/S0022215110000022. Epub 2010 Feb 24.
We report a rare case of a nasal glioma found incidentally in an adult, presenting with visual loss, optic nerve oedema and proptosis.
A 41-year-old woman presented with bilateral proptosis, impairment in visual acuity (6/60 bilaterally) and loss of colour vision. Computed tomography and magnetic resonance imaging showed proptosis, bilateral optic nerve swelling and a heterogeneous mass occupying the left nasal cavity and extending through a skull base defect into the anterior cranial fossa. Biopsy confirmed a nasal glioma. Treatment with intravenous dexamethasone resolved the proptosis, and the patient's visual acuity recovered to 6/9 bilaterally. At the multidisciplinary team meeting, it was felt that the nasal glioma probably represented an incidental finding and was not directly responsible for the patient's proptosis and transient visual loss.
To our knowledge, this is the first report in the English language literature of adult nasal glioma presenting with visual loss. The management of nasal gliomas in adults is contentious and the relevant literature is reviewed. This case was managed conservatively with regular follow up.
我们报告一例罕见的成人偶然发现的鼻胶质瘤病例，该病例表现为视力丧失、视神经水肿和眼球突出。
一名41岁女性出现双侧眼球突出、视力损害（双侧均为6/60）和色觉丧失。计算机断层扫描和磁共振成像显示眼球突出、双侧视神经肿胀以及一个异质性肿块，占据左侧鼻腔并通过颅底缺损延伸至前颅窝。活检证实为鼻胶质瘤。静脉注射地塞米松治疗后眼球突出消退，患者视力双侧恢复至6/9。在多学科团队会议上，认为鼻胶质瘤可能是偶然发现的，并非直接导致患者眼球突出和短暂视力丧失的原因。
据我们所知，这是英文文献中首例出现视力丧失的成人鼻胶质瘤报告。成人鼻胶质瘤的治疗存在争议，现对相关文献进行综述。该病例采用保守治疗并定期随访。
