Djambazov Karen B, Kitov Borislav D, Zhelyazkov Christo B, Davarski Atanas N, Topalova Alexandrina R
1Department of Ear, Nose and Throat Diseases, Faculty of Medicine, Medical University of Plovdiv, Plovdiv, Bulgaria.
2Department of Neurosurgery, Faculty of Medicine, Medical University of Plovdiv, Plovdiv, Bulgaria.
Folia Med (Plovdiv). 2017 Dec 20;59(4):481-485. doi: 10.1515/folmed-2017-0049.
Mucocele of the paranasal sinuses is a rare disease with slow evolution. It is a benign, encapsulated and destructive formation filled with mucous fluid and tapistrated with respiratory epithelium. Of all the paranasal sinuses, the sphenoid sinus is affected in only 1-7% of the cases. We present two cases of mucocele of the sphenoid sinus involving the posterior ethmoidal cells. We consider here their clinical presentation, use of neuroimaging in the diagnosis, surgical care and postoperative results. Both patients presented with a history of persistent headache and in addition, one of them had a paresis of the right oculomotor and abducens nerves. A transnasal endoscopic sphenoidectomy was performed in both patients, in one - with an evacuation of the mucocele and marsupialization, and in the other - with a balloon dilatation of the natural foramen of the sinus. Postoperatively, a complete reversal of the symptoms was observed in both patients. Mucocele of the paranasal sinuses should be considered as a diagnosis in cases of persistent headache with a primarily retrobulbar location and eye symptoms. Computed tomography and magnetic resonance imaging can be used to successfully diagnose the disease. The transnasal endoscopic sphenoidectomy is the therapeutic method of choice which allows evacuation of the mucocele, while the marsupialization allows good drainage and prevents recurrence.
鼻窦黏液囊肿是一种罕见的疾病，发展缓慢。它是一种良性、有包膜且具有破坏性的肿物，充满黏液，内衬呼吸上皮。在所有鼻窦中，蝶窦受累的病例仅占1 - 7%。我们报告两例累及后筛窦的蝶窦黏液囊肿病例。在此我们探讨其临床表现、诊断中神经影像学的应用、手术治疗及术后结果。两名患者均有持续性头痛病史，此外，其中一名患者右侧动眼神经和展神经麻痹。两名患者均接受了经鼻内镜蝶窦切除术，其中一例进行了黏液囊肿清除及袋形缝合术，另一例进行了鼻窦自然开口的球囊扩张术。术后，两名患者的症状均完全缓解。对于主要表现为球后部位持续性头痛和眼部症状的病例，应考虑鼻窦黏液囊肿的诊断。计算机断层扫描和磁共振成像可用于成功诊断该病。经鼻内镜蝶窦切除术是首选的治疗方法，可清除黏液囊肿，而袋形缝合术可实现良好引流并预防复发。
