孤立性蝶窦疾病的诊断及其鼻内镜手术治疗  

Diagnosis and endoscopic treatment of isolated sphenoid sinus disease

作　　者：陈翊民[1] 邱连升[1] 邱金梅[1] 

机构地区：[1]福建医科大学第二临床医学院耳鼻咽喉科,福建泉州362000

出　　处：《临床耳鼻咽喉头颈外科杂志》2014年第11期760-763,共4页Journal of Clinical Otorhinolaryngology Head And Neck Surgery

摘　　要：目的:探讨孤立性蝶窦疾病的临床特点、影像学特征和鼻内镜手术的疗效。方法:38例孤立性蝶窦疾病患者,35例行鼻窦CT(其中5例同时行MRI),3例行单纯鼻窦MRI,1例行脑池CT造影。所有患者均行鼻内镜下蝶窦开放术,其中有33例采用经鼻腔嗅裂径路,5例采用经前筛-后筛径路(即Messerklinger技术)。结果:术后随访6个月以上,34例病情完全控制,4例部分控制。术中和术后均未出现严重并发症。结论:孤立性蝶窦疾病临床症状不典型,无特异性,鼻部检查多无阳性体征,仅有以头痛为主诉的神经系统症状,早期常难以确诊。鼻窦CT和MRI是诊断孤立性蝶窦炎的最佳手段,而鼻内镜手术则是治疗该病的首选方法。Objective： This study was to investigate the clinical symptoms, characterization of imaging technique and the effect of endonasal endoscopic surgery. Method.. Following 38 cases of isolated sphenoid sinus disease patients, among whom 35 cases treated with nasal sinus CT （including 5 cases of MRI at the same time）, 3 cases undergoing sinus MRI, 1 cases going through the CT cisternography. All patients underwent endoscopic sphenoid- otomy, of which 33 cases underwent nasal olfactory cleft approach, 5 cases anterior ethmoid sinus and posterior ethmoid sinus approach （Messerklinger technology）. Result： All patients were followed up for more than half a year, of which 34 were recoverd and 4 were improved. No obvious complications came up during or after endoscopic surgery. Conclusion：Isolated sphenoid sinus disease clinical symptoms are not typicaland without specialty; nasal examination had no positive sign, only with headache as the chief neurological symptom, often difficult to diagnose at an early stage. The CT and MRI are the best methods for the diagnosis of isolated sphenoid sinusitis. The nasal endoscopic operation is the preferred method for treatment of this disease.

关 键 词：蝶窦 内镜检查 磁共振成像 

分 类 号：R765.4[医药卫生—耳鼻咽喉科]