Kitthaweesin Kitthisak, Theerakul Triyapa
Department of Ophthalmology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.
J Med Assoc Thai. 2012 Dec;95(12):1543-7.
To describe neuro-ophthalmic manifestations in sinusitis patients who underwent functional endoscopic sinus surgery
The medical records of 341 patients who underwent functional endoscopic sinus surgery (FESS) between October and January 2001 were reviewed in this retrospective study.
Patient mean age was 37.09 years (range, 3-77) and 171 (50.15%) patients had no underlying disease. Visual loss and limited ocular motility were revealed in 43 (12.72%) and 40 (11.83%) patients, respectively Sphenoid sinus was the most commonly affected sinus in patients presenting with either visual loss (odds ratio 5.88; 95% CI 2.79-12.38) or ophthalmoplegia (OR 7.09; 95% CI 3.28-15.32). Twenty-three percent of patients with visual loss had abnormal funduscopy, while 30.23% had abnormal radiologic imaging study. After FESS, 12 (27.91%) patients had better visual acuity, but 11 (25.58%) had permanent visual loss. Isolated oculomotor and combined oculomotor with abducens nerve involvement were revealed in nine (22.50%), and 31 (77.5%) patients, respectively. Diabetes was a significant risk factor associated with ocular complications in patients with either visual loss (OR 2.98; 95% CI 1.37-6.44) or ophthalmoplegia (OR 2.56; 95% CI 1.17-5.61).
Sphenoid sinusitis significantly increased the risk of neuro-ophthalmic manifestations, particularly among diabetic patients.
描述接受功能性鼻内镜鼻窦手术的鼻窦炎患者的神经眼科表现
在这项回顾性研究中，对2001年10月至1月期间接受功能性鼻内镜鼻窦手术（FESS）的341例患者的病历进行了回顾。
患者平均年龄为37.09岁（范围3 - 77岁），171例（50.15%）患者无基础疾病。分别有43例（12.72%）和40例（11.83%）患者出现视力丧失和眼球运动受限。在出现视力丧失（优势比5.88；95%可信区间2.79 - 12.38）或眼肌麻痹（优势比7.09；95%可信区间3.28 - 15.32）的患者中，蝶窦是最常受累的鼻窦。23%视力丧失的患者眼底检查异常，而30.23%的患者影像学检查异常。FESS术后，12例（27.91%）患者视力改善，但11例（25.58%）患者出现永久性视力丧失。分别有9例（22.50%）和31例（77.5%）患者出现孤立性动眼神经麻痹以及动眼神经合并展神经受累。糖尿病是视力丧失（优势比2.98；95%可信区间1.37 - 6.44）或眼肌麻痹（优势比2.56；95%可信区间1.17 - 5.61）患者眼部并发症的显著危险因素。
蝶窦炎显著增加了神经眼科表现的风险，尤其是在糖尿病患者中。
