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鼻窦黏液囊肿:8例系列病例回顾性分析

Mucocele of the Paranasal Sinuses: Retrospective Analysis of a Series of Eight Cases.

作者信息

Magboul Nasir A, Alzubaidi Atheer A, Abumsmar Lamya A, Alzarei Ali, Al-Ahmari Mohammad, Alshehri Mona A

机构信息

ENT, Armed Forces Hospital, Jazan, SAU.

Otolaryngology - Head and Neck Surgery, Khamis Mushait General Hospital, Khamis Mushait, SAU.

出版信息

Cureus. 2023 Jul 17;15(7):e41986. doi: 10.7759/cureus.41986. eCollection 2023 Jul.

Abstract

BACKGROUND

Paranasal sinus mucoceles are epithelium-lined cystic masses usually resulting from obstruction of sinus ostia. They most frequently occur in the frontal and ethmoid sinuses. The etiology is not clarified, but the most common identifiable cause of mucoceles following functional endoscopic sinus surgery (FESS), trauma, neoplasms, and allergy. The clinical symptoms of mucocele vary and are not specific, the most common being ophthalmic symptoms and headache, impinging on adjacent orbital structures, and causing ophthalmic sequelae such as double vision, commonly followed by orbital swelling, epiphora, proptosis, and ptosis. All patients in this study had frontal and frontoethmoidal mucocele and initially complained of frontal headache and ophthalmic symptoms. Definitive treatment options for paranasal sinus mucoceles include external approaches and endoscopic marsupialization.  Objective: The study aimed to identify the etiology, clinical presentation, most common para nasal sinus affected by mucocele, management, and the rate of recurrence in eight cases with mucocele of the paranasal sinuses.

METHODS

Eight patients diagnosed with mucocele of the paranasal sinuses were admitted to our institution between 2014 and 2021. There were two females and six males aged between 14 and 67. Initial symptoms, duration, clinical presentation upon admission, location of the mucocele, type of surgical intervention, and outcome have all been studied.  Results: The most common symptoms at diagnosis were orbital involvement, retrobulbar, and frontal headache. Most patients were diagnosed with frontal mucocele (40%), and three were frontoethmoidal mucocele at the time of presentation. The rest of the cases were diagnosed with ethmoidal mucocele (25%). The etiology was identified in four patients and was unclear in the rest. All patients underwent endoscopic sinus surgery. The most identifiable postoperative complication was a headache.

CONCLUSIONS

The endonasal endoscopic approach is a safe and effective treatment for paranasal sinus mucocele and provides adequate drainage with a low recurrent rate.

摘要

背景

鼻窦黏液囊肿是内衬上皮的囊性肿物,通常由鼻窦开口阻塞引起。它们最常发生于额窦和筛窦。病因尚不明确,但鼻窦黏液囊肿最常见的可识别病因是功能性鼻内镜鼻窦手术(FESS)、外伤、肿瘤和过敏。黏液囊肿的临床症状多样且不具特异性,最常见的是眼部症状和头痛,压迫相邻眼眶结构,导致复视等眼部后遗症,随后常伴有眼眶肿胀、流泪、眼球突出和上睑下垂。本研究中的所有患者均患有额窦和额筛窦黏液囊肿,最初均主诉额部头痛和眼部症状。鼻窦黏液囊肿的确定性治疗方案包括外部入路和内镜下造袋术。目的:本研究旨在确定8例鼻窦黏液囊肿患者的病因、临床表现、受黏液囊肿影响最常见的鼻窦、治疗方法及复发率。

方法

2014年至2021年期间,8例诊断为鼻窦黏液囊肿的患者入住我院。其中女性2例,男性6例,年龄在14岁至67岁之间。对初始症状、持续时间、入院时的临床表现、黏液囊肿位置、手术干预类型及结果进行了研究。结果:诊断时最常见的症状是眼眶受累、球后及额部头痛。大多数患者诊断为额窦黏液囊肿(40%),3例在就诊时为额筛窦黏液囊肿。其余病例诊断为筛窦黏液囊肿(25%)。4例患者病因明确,其余患者病因不明。所有患者均接受了鼻内镜鼻窦手术。最常见的术后并发症是头痛。

结论

鼻内镜入路是治疗鼻窦黏液囊肿的一种安全有效的方法,能提供充分引流且复发率低。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a33b/10427889/3fc766591996/cureus-0015-00000041986-i01.jpg

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