孤立性蝶窦炎性疾病的诊治  

The diagnosis and treatment of isolated sphenoid sinus disease

作　　者：张楠[1] 王力红[1] 安惠明[1] 梁传余[1] 

机构地区：[1]四川大学华西医院耳鼻咽喉科,成都610041

出　　处：《临床耳鼻咽喉科杂志》2001年第11期489-490,共2页Journal of Clinical Otorhinolaryngology

摘　　要：目的 :提高对孤立性蝶窦炎性疾病症状、体征的认识和首诊准确率。方法 :分析 4 9例孤立性蝶窦炎性疾病的临床表现 ,比较非内窥镜手术 10例和内窥镜手术 39例的手术效果。结果 :未经鼻窦内窥镜手术者 ,1例行蝶窦灌洗后头痛立即缓解 ,4例症状在 1周内缓解 ,5例 2～ 4个月后症状复发 ,窦口瘢痕狭窄阻塞 ,需手术切开引流。经鼻窦内窥镜蝶窦开放术者 ,治愈 31例 ,其中 10例手术后症状立即消失 ,2 1例术后 3～ 5d症状缓解 ;好转 8例 ,其中 5例仅感轻微头痛和嗅觉失灵 ,鼻内窥镜见窦口粘膜肿胀 ,CT、MRI复查未见窦腔病变 ;3例术后2个月视力恢复。术后 1个月复诊窦口开放率为 87.2 %。随访 6～ 4 8个月无病变及症状复发 ,未再次手术。结论 :孤立性蝶窦炎经CT或MRI等高清晰度的影像学检查加之以鼻窦内窥镜检查均可明确诊断 。Objective:To detail the underlying symptoms and signs of patients with isolated sphenoid sinus inflammatory disease and enhance the initial diagnostic accuracy.Method:49 patients with isolated sphenoid sinus inflamatory disease were reviewed,and the outcomes of the endoscopic surgery were compared with the non endoscopic surgery.Result:In patients who underwent endoscopic sphenoidotomy,31 were virtually free from symptoms and 5 still experienced mild headache and hyposmia but their radiographic finding had become normalized.None of them need re operation within 6～48 months follow up.However,in patients with non endoscopic sinus irrigation,only one was free from the symptoms and 5 patients underwent re operation because of recurrence.Conclusion:Nasal endoscopy and CT/MRI scan could provide a precise diagnosis for isolated sphenoid sinus disease and endoscopic surgery is valuable in its treatment.

关 键 词：蝶窦炎 鼻内窥镜手术 CT MRI 

分 类 号：R765.44[医药卫生—耳鼻咽喉科]