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21例孤立性蝶窦病变的临床诊断与治疗经验报道

Clinical diagnosis and treatment experience of 21 case report of isolated sphenoid sinus lesions.

作者信息

Yu Ziwei, Yu Yanli, Chen Xudong, Wang Yaowen, Cheng Peng

机构信息

Department of Otolaryngology, Head and Neck Surgery, The First Affiliated Hospital of Ningbo University, Ningbo, Zhejiang, China.

出版信息

Medicine (Baltimore). 2025 Mar 21;104(12):e41812. doi: 10.1097/MD.0000000000041812.

DOI:10.1097/MD.0000000000041812
PMID:40128038
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11936579/
Abstract

RATIONALE

With the rapid development of medical science and technology, imaging has become an important part of the diagnosis of diseases, which can provide important information about the morphology and scope of the lesion and its relationship with the surrounding tissues. However, due to the fact that isolated pterygoid sinus lesions often have atypical clinical symptoms, and the location of the lesion is deep and the anatomical structure is complex, its diagnosis still faces one of the important challenges, and the misdiagnosis rate is high. The aim of this study was to explore the clinical symptoms, imaging manifestations, and postoperative pathological features of isolated pterygoid sinus lesions, and to summarize the key points of their diagnosis through systematic retrospective analysis, with a view to providing references for clinicians, reducing the misdiagnosis rate of this disease, and improving the level of diagnosis and treatment.

PATIENT CONCERNS

A retrospective analysis was conducted on the clinical data of 21 patients with isolated sphenoid sinus lesions diagnosed and treated in the ENT department of our hospital from January 2021 to January 2023. Among them, there were 12 cases of headache, 1 case of eye symptoms, 10 cases of nasal symptoms, and 1 case of facial symptoms upon admission.

DIAGNOSES

Among the 21 cases, there were 10 cases of fungal sphenoid sinus inflammation, 3 cases of sphenoid sinus cyst, 4 cases of chronic sphenoid sinus inflammation, 1 case of sphenoid sinus polyp, 1 case of skull base schwannoma, 1 case of inverted papilloma of sphenoid sinus, and 1 case of cerebrospinal fluid rhinorrhea.

INTERVENTIONS

In this study, 21 patients underwent endonasal endoscopic pterygoid sinus opening, and all symptoms improved after surgery.

OUTCOMES

The specific type and clinical manifestations of 21 cases of isolated pterygoid sinus lesions were clarified by imaging and postoperative pathological analysis.

LESSONS

Isolated pterygoid sinus lesions vary in type, and clinicians should combine clinical symptoms and imaging manifestations to improve diagnostic accuracy and reduce misdiagnosis. Systematic retrospective analysis helps to summarize diagnostic points and improve reference for clinical practice. Clinical symptoms and imaging examinations help to avoid misdiagnosis of this type of disease.

摘要

理论依据

随着医学科学技术的飞速发展,影像学已成为疾病诊断的重要组成部分,可提供有关病变形态、范围及其与周围组织关系的重要信息。然而,由于孤立性蝶窦病变往往具有非典型临床症状,且病变位置深、解剖结构复杂,其诊断仍面临重要挑战之一,误诊率较高。本研究旨在探讨孤立性蝶窦病变的临床症状、影像学表现及术后病理特征,通过系统回顾性分析总结其诊断要点,以期为临床医生提供参考,降低该病误诊率,提高诊疗水平。

患者情况

回顾性分析2021年1月至2023年1月在我院耳鼻喉科诊治的21例孤立性蝶窦病变患者的临床资料。其中,入院时头痛12例,眼部症状1例,鼻部症状10例,面部症状1例。

诊断结果

21例中,真菌性蝶窦炎10例,蝶窦囊肿3例,慢性蝶窦炎4例,蝶窦息肉1例,颅底神经鞘瘤1例,蝶窦内翻性乳头状瘤1例,脑脊液鼻漏1例。

干预措施

本研究中,21例患者接受鼻内镜下蝶窦开放术,术后所有症状均改善。

结果

通过影像学及术后病理分析明确了21例孤立性蝶窦病变的具体类型及临床表现。

经验教训

孤立性蝶窦病变类型多样,临床医生应结合临床症状及影像学表现提高诊断准确性,减少误诊。系统回顾性分析有助于总结诊断要点,提高对临床实践的参考价值。临床症状及影像学检查有助于避免此类疾病的误诊。

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