Paradowska-Opałka Beata, Kawczyński Maciej, Jaworowska Ewa
Katedra i Klinika Laryngologii i Onkologii Laryngologicznej Pomorskiego Uniwersytetu Medycznego w Szczecinie, Kierownik p.o. dr med. E. Jaworowska, Poland.
Otolaryngol Pol. 2013 Sep-Oct;67(5):261-4. doi: 10.1016/j.otpol.2012.05.018. Epub 2012 May 23.
Paranasal sinus mucocele is the cystic formation lined by inflammatory changed mucoperiosteum. This is slow-growing pathology with a tendency to bone erosion. The symptoms are dependent on the direction of the penetration, and are as follows: increasing headaches, deformations of frontal or orbital region, ophthalmic manifestations such as lacrimation, decreased visual acuity, exophthalmos, ocular movement limitation, diplopia. The most common location of the mucocele is fronto-ethmoid region. The most useful diagnostic tests are a magnetic resonance imaging (MRI) and a computed tomography (CT) which show the progress of the disease and bone destructions. Surgery is the only method of treatment (external approach or FESS). This paper reports the case of a 74-year-old woman with ethmoid mucocele penetrating into the orbit, frontal sinus and anterior cranial fossa with compression of frontal lobe of the brain. The patient underwent CT and MRI and was treated with endoscopic intranasal marsupialization of the cyst. There are no clinical signs of disease recurrence 7 months after surgery. The endoscopic surgical management in treatment of sinus mucocele is a good alternative to the operation from external approach because of its low invasiveness, low complication risk, rapid healing and good therapeutic effects.
鼻窦黏液囊肿是一种由炎性改变的黏膜骨膜衬里的囊性结构。这是一种生长缓慢的病变，有骨质侵蚀的倾向。症状取决于其侵袭方向，如下：头痛加剧、额部或眶部区域变形、眼部表现，如流泪、视力下降、眼球突出、眼球运动受限、复视。黏液囊肿最常见的部位是额筛区域。最有用的诊断检查是磁共振成像（MRI）和计算机断层扫描（CT），它们能显示疾病进展和骨质破坏情况。手术是唯一的治疗方法（外部入路或功能性鼻内镜鼻窦手术）。本文报道了一例74岁女性患者，其筛窦黏液囊肿侵入眼眶、额窦和前颅窝并压迫脑额叶。该患者接受了CT和MRI检查，并接受了囊肿内镜下经鼻造袋术治疗。术后7个月无疾病复发的临床迹象。由于其微创性、低并发症风险、愈合快及良好的治疗效果，内镜手术治疗鼻窦黏液囊肿是外部入路手术的良好替代方法。
