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沉默性窦综合征:鼻窦手术与眼眶重建联合治疗——15例报告

Silent sinus syndrome: combined sinus surgery and orbital reconstruction - report of 15 cases.

作者信息

Clarós Pedro, Sobolewska Aleksandra Zofia, Cardesa Antonio, Lopez-Fortuny Marta, Claros Andres

机构信息

a Department of Otolaryngology - Orbital Surgery, Clinica Clarós , Barcelona , Spain.

b Department of Otolaryngology , Stefan Żeromski Hospital , Cracow , Poland.

出版信息

Acta Otolaryngol. 2019 Jan;139(1):64-69. doi: 10.1080/00016489.2018.1542161. Epub 2019 Feb 3.

Abstract

BACKGROUND

Silent sinus syndrome (SSS) is defined as spontaneous, painless enophthalmos, hypoglobus with orbital floor resorption and maxillary sinus collapse on the ipsilateral side. Different methods of orbital floor reconstruction have been proposed.

AIMS/OBJECTIVES: The purpose was to analyse the results of combined endoscopic sinus surgery (ESS) and reconstruction using orbital floor implant of 15 patients with SSS and to present recent histological findings.

MATERIALS AND METHODS

Retrospective case review of 15 patients with SSS treated in clinic between 2007 and 2017.

RESULTS

Eleven women and four men presented with unilateral, spontaneous enophthalmos. Averaged duration of enophthalmos was 10.7 months. On affected side, mean enophthalmos was 2.6 mm and hypoglobus 2.7 mm. Computed tomography imaging (CT) imaging showed maxillary sinus opacification on the affected side in every case, and the orbital floor was displaced downwards in all cases. In total, 13 patients underwent simultaneous ESS and rebuilding of orbital floor with a titanium implant. Statistical analysis confirmed significant differences for pre- and postoperative measure of enophthalmos and hypoglobus.

CONCLUSION AND SIGNIFICANCE

Implementation of titanium implants is the reliable method of reconstruction that allows good aesthetic result, shorter time of procedure with an excellent long-term outcome and satisfactory patient's tolerance.

摘要

背景

沉默性窦综合征(SSS)定义为同侧自发性、无痛性眼球内陷、眼球下移伴眶底吸收及上颌窦塌陷。已经提出了不同的眶底重建方法。

目的

分析15例沉默性窦综合征患者联合内镜鼻窦手术(ESS)及使用眶底植入物进行重建的结果,并展示近期的组织学发现。

材料与方法

对2007年至2017年间在诊所治疗的15例沉默性窦综合征患者进行回顾性病例分析。

结果

11名女性和4名男性表现为单侧自发性眼球内陷。眼球内陷的平均持续时间为10.7个月。患侧平均眼球内陷2.6毫米,眼球下移2.7毫米。计算机断层扫描成像(CT)显示所有病例患侧上颌窦均有混浊,且所有病例眶底均向下移位。共有13例患者同时接受了ESS和钛植入物眶底重建。统计分析证实,术前和术后眼球内陷及眼球下移测量结果存在显著差异。

结论及意义

钛植入物的应用是一种可靠的重建方法,可获得良好的美学效果,手术时间短,长期效果良好,患者耐受性满意。

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