Matsuba Yumiko, Strassen Ulrich, Hofauer Benedikt, Bas Murat, Knopf Andreas
Hals-, Nasen-, Ohrenklinik und Poliklinik, Klinikum rechts der Isar, Technische Universität München, Ismaninger Straße 22, 81675, Munich, Germany.
Eur Arch Otorhinolaryngol. 2015 Sep;272(9):2319-26. doi: 10.1007/s00405-014-3338-2. Epub 2014 Oct 17.
To evaluate the clinical course of orbital complication using a standardised diagnostic pathway. Seventy-three patients with orbital complications underwent a multimodal diagnostic pathway comprising ENT examination, leucocytes/CRP, CT-/MRI-scanning and disease-related data. Twenty-nine patients suffered from rhinosinusitis, 28 from mucoceles, 13 patients from neoplasms and three patients from rheumatic disorders. Clinical examination diagnosed 60 patients with eyelid swelling, 55 patients with ocular pain, 14 patients with diplopia, 4 patients with exophthalmus, 29 patients with visual field defect and 4 patients with visual loss. The diagnostic pathway identified acute rhinosinusitis with a sensitivity/specificity of 90 %/90 %, mucoceles with 79 %/100 %, neoplasms with 100 %/96 % and granulomatosis with polyangiitis with 100 %/100 %, respectively. All patients left the hospital in good general condition and with regular ocular motility; two patients suffered persistent visual loss. The standardised application of a widely accepted diagnostic pathway reliably distinguishes different causes of orbital complication.
采用标准化诊断途径评估眼眶并发症的临床病程。73例眼眶并发症患者接受了包括耳鼻喉科检查、白细胞/CRP、CT/MRI扫描及疾病相关数据的多模式诊断途径。29例患者患有鼻窦炎，28例患有黏液囊肿，13例患有肿瘤，3例患有风湿性疾病。临床检查诊断出60例患者有眼睑肿胀，55例患者有眼痛，14例患者有复视，4例患者有眼球突出，29例患者有视野缺损，4例患者有视力丧失。该诊断途径识别急性鼻窦炎的敏感度/特异度分别为90%/90%，黏液囊肿为79%/100%，肿瘤为100%/96%，肉芽肿性多血管炎为100%/100%。所有患者出院时一般状况良好，眼球运动正常；2例患者持续视力丧失。广泛接受的诊断途径的标准化应用能够可靠地区分眼眶并发症的不同病因。
