累及颅内的蝶窦粘液囊肿(3例报告)  

Sphenoidal sinus mucocele with intracranial extension(A report of 3 cases)

作　　者：肖自安[1] 贺湘波[1] 谢鼎华[1] 

机构地区：[1]中南大学湘雅二医院耳鼻咽喉科,湖南长沙410011

出　　处：《中国耳鼻咽喉颅底外科杂志》2002年第2期84-86,共3页Chinese Journal of Otorhinolaryngology-skull Base Surgery

摘　　要：目的总结侵犯颅内的蝶窦粘液囊肿的临床特征及预后.方法回顾性分析近6年来我院收治的3例侵及颅内的蝶窦粘液囊肿的临床资料.结果 3例巨大蝶窦粘液囊肿分别有不同程度的蝶鞍部、斜坡和中颅窝等颅内侵犯,除鼻部症状外,共同的临床表现是较剧烈的持续性头痛;1例合并右眼视力下降仅有光感,1例合并双眼视力减退,1例有左侧外展神经麻痹;3例均无内分泌症状.3例病人均行鼻内镜蝶窦粘液囊肿切除术,术后头痛迅速缓解,受损脑神经部分恢复;术后1～2个月均头痛完全消失,分别有双眼视力轻度下降和左侧三叉神经麻痹的2例病人在术后1个月完全恢复,另1例右眼视力仅有光感者术后随访1年视力无好转.结论侵及颅内的蝶窦粘液囊肿常表现为持续性头痛、脑神经麻痹和不同程度的视力下降,其中持续性头痛是最常见症状;术后视力恢复的程度与术前视力受损时间和程度有关.鼻内镜蝶窦粘液囊肿切除术是一种较简便、安全、有效的治疗方法.ve To summarize the clinical characteristics and prognosis of the sphenoidal sinus mucocele with intracranial extension. Methods The clinical data of 3 patients suffering from massive sphenoidal sinus mucocele with intracranial extension were analyzed retrospectively. Results There were different degrees of intracranial extension to sella turcica region, clivus and intermediate cranial fossa in the 3 patients. The symptoms included severe headache, poor light perception and deterioration of visual acuity in 2 patient, and left abducent nerve paralysis in 1 patient. No endocrine symptoms were presented. All symptoms in the 3 patients gradually disappeared in 1 ~ 2 months after the resection of sphenoidal mucocele by endoscopic sinus technique. One patient who had poor light perception in the right eye did not recover her vision one year after the operation. Conclusion Sphenoidal sinus mucocele with intracranial extension is characterized by persistent headache, cranial nerve palsies, and vision loss. Severe persistent headache is the most common symptom. The recovery depends on early diagnosis and treatment. Complete resolution of the disorder is possible by transsphenoidal eradication with the endoscopic sinus surgery, a safe and simple procedure.

关 键 词：蝶窦粘液囊肿 外科学 颅内侵犯 病理报告 

分 类 号：R765.44[医药卫生—耳鼻咽喉科]