Wu P Z, Sun W, Wen Y H, Ma R Q, Zhu X L, Wen W P
Department of Otorhinolaryngology, The First Affiliated Hospital, Otorhinolaryngology Institute, Sun Yat-sen University, Guangzhou, Peoples Republic of China.
Rhinology. 2017 Sep 1;55(3):281-287. doi: 10.4193/Rhin16.341.
Different from rhinoliths, the paranasal gossypiboma is a foreign body, such as a surgical sponge, left in the nasal cavity. It is a rare, frequently misdiagnosed disease that has rarely been reported. We summarize its clinical characteristics, management, and possible risk factors.
We reviewed medical records of confirmed paranasal gossypibomas at a tertiary medical center between 2005 and 2015. Clinical symptoms, age, sex, anatomic sites, endoscopic photography, computed tomography, intraoperative findings, and past medical history were reviewed.
The study included 21 patients, each of whom had ultimately undergone two operations. Among them, 20 underwent endoscopic nasal surgery in primary hospitals, and 15 had been misdiagnosed during the second surgery. The average interval to discovery of a retained foreign body was 200 days. Predominant occurrence sites were the maxillary and ethmoid sinuses. Computed tomography showed paranasal gossypiboma as a heterogeneous cystic lesion with a thin calcified shell.
A history of endoscopic nasal surgery, especially performed at a primary hospital, is a warning sign for clinicians. Computed tomography can add to the warning by showing a heterogeneous cystic lesion with a thin calcified shell. Clinicians should be aware of these characteristics to avoid misdiagnosing paranasal gossypiboma.
与鼻石不同，鼻窦棉球瘤是留在鼻腔内的异物，如手术海绵。它是一种罕见的、常被误诊的疾病，鲜有报道。我们总结其临床特征、治疗方法及可能的危险因素。
我们回顾了2005年至2015年期间一家三级医疗中心确诊的鼻窦棉球瘤患者的病历。对临床症状、年龄、性别、解剖部位、内镜照片、计算机断层扫描、术中发现及既往病史进行了回顾。
该研究纳入21例患者，每人最终均接受了两次手术。其中，20例在基层医院接受了鼻内镜手术，15例在二次手术时被误诊。发现异物残留的平均间隔时间为200天。主要发生部位为上颌窦和筛窦。计算机断层扫描显示鼻窦棉球瘤为具有薄钙化壳的异质性囊性病变。
鼻内镜手术史，尤其是在基层医院进行的手术，对临床医生来说是一个警示信号。计算机断层扫描通过显示具有薄钙化壳的异质性囊性病变可增加警示作用。临床医生应了解这些特征，以避免误诊鼻窦棉球瘤。
