鼻内镜手术治疗鼻眼相关性疾病27例分析  

The nasal endoscopic surgery for the treatment of nose-eye correlated diseases:27 cases analysis

作　　者：樊建刚[1] 陈力[2] 李静娴[1] 古庆家[1] 李德炳[1] 赵李冰[1] 何刚[1] 

机构地区：[1]四川省医学科学院.四川省人民医院耳鼻咽喉头颈外科,四川成都610072 [2]四川省医学科学院.四川省人民医院眼科,四川成都610072

出　　处：《实用医院临床杂志》2016年第2期92-95,共4页Practical Journal of Clinical Medicine

摘　　要：目的探讨鼻内镜下治疗鼻眼相关疾病的手术方式的选择和对预后的影响。方法回顾性分析在我院住院并行鼻内镜或鼻内镜辅助手术治疗的27例鼻眼相关性疾病患者的临床资料,分析总结其手术方式及治疗效果。结果 27例患者均经鼻内镜或鼻内镜辅助下完成手术。术后随访时间3~24月,平均随访时间12月。其中,1例眶周骨折伴泪道阻塞患者内镜下手术失败,改为鼻外径路鼻腔泪囊造孔术;1例眶内高分化脂肪肉瘤复发,1例因考虑眶内淋巴瘤而放弃治疗;1例眶内扩张性静脉畸形术后视力下降,经治疗后恢复;1例骨纤维异常增殖症患者病变部分残余,1例外伤性视神经病患者3月后失访;1例慢性侵袭性真菌性鼻窦炎患者术后改为长期抗微生物治疗;其余患者术后随访结果良好。结论经鼻内镜手术或内镜辅助下手术治疗鼻眼相关性疾病具有独特优势,但也有失败和产生严重并发症的可能。对于鼻内镜手术或内镜辅助下手术治疗鼻眼相关性疾病的手术径路、方法、原则、范围等方面仍需不断探讨和严格的界定。Objective To investigate the different choices of operations with endoscope in the treatment of nose-eye correlated diseases and their influence on patients＇ prognosis.Methods The clinical data of 27 patients with nose-eye correlated diseases treated in our hospital with nasal endoscopic surgery or endoscopic assistant surgery were retrospectively analyzed.Surgical methods and therapeutic effect were summarized.Results All the operations for these patients were completed through endoscope or assistant with endoscope.The follow-up time differed from 3 months to 24 months with average of 12 months. Among them,the operation for one case who suffered from periorbital fracture with lacrimal duct obstruction failed and the dacryocystorhinostomy with external path was performed.One case with orbital well-differentiated liposarcoma relapsed.One case gave up treatment due to consideration of orbital lymphoma.One case with orbital expansionary venous malformations suffered from postoperative vision loss,but his vision was recovered after treatment.One patient with fibrous dysplasia left residual lesions. One case with traumatic optic neuropathy lost to follow-up 3 months later. One case with chronic invasive fungal rhinosinusitis got on to long-term antimicrobial treatment postoperatively. Postoperative follow-up results of other patients were good.Conclusion The endoscopic surgery or endoscope assistant surgery for nose-eye correlated diseases has unique advantages. However,there is possibility of failure and serious complications. Therefore,it should constantly explore and strictly definite the operation path,methods,principles and scope for the treatment of the diseases.

关 键 词：鼻 鼻内镜手术 鼻眼相关疾病 鼻窦 眼眶 

分 类 号：R765[医药卫生—耳鼻咽喉科]