鼻外切口联合鼻内镜下经鼻腔治疗鼻眼相关性疾病  

The treatment of nose-eye correlated diseases with external nasal incision combined with nasal cavity approach surgery through endoscope

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,成都610072 [2]四川省医学科学院四川省人民医院眼科

出　　处：《临床耳鼻咽喉头颈外科杂志》2016年第15期1210-1214,共5页Journal of Clinical Otorhinolaryngology Head And Neck Surgery

摘　　要：目的：探讨采用鼻外切口联合鼻内镜下经鼻腔双径路手术治疗鼻眼相关性疾病的适应证和特点。方法：回顾性分析在我科确诊并经鼻外切口及鼻内镜下经鼻腔双径路手术治疗的13例患者的临床资料。4例患者行鼻内镜下经鼻腔及泪阜结膜切口手术,4例采用鼻内镜下经鼻腔及原外伤创口双径路骨折复位加泪囊鼻腔造孔术,2例采用鼻内镜下经鼻腔加鼻外切口双径路骨瘤切除术,其余3例采用鼻内镜下经鼻腔及眶周切口手术。结果：2例肿瘤患者随访1.5-2年,未见复发;2例眶内壁骨折患者复视消失;4例眶壁骨折伴泪道阻塞患者中,3例手术成功,1例手术失败改为鼻外切口泪囊造孔术,溢泪均消失;鼻窦骨瘤、异物及脓肿患者全部治愈,症状消失;异位脑膜瘤患者症状消失,遗留眉弓处瘢痕。结论：采用鼻内镜辅助下经鼻外切口及鼻腔双径路手术治疗鼻眼相关性疾病具有视野清晰、损伤较小的特点,可以有效地处理相关病变,但是其确切的适应证和手术方式仍需进一步探究。Objective：To explore the indications and characteristics for the treatment of nose-eye correlated diseases with endoscopic surgery through external nasal incision combined with nasal cavity approach.Method：The clinical data of 13 patients whom hospitalized in our department and treated by endoscopic surgery through external nasal incision combined with nasal cavity approach since October 2011,were retrospectively analyzed and the characteristics of different pathological changes,clinical manifestations,surgical approach and follow-up results were summarized.Four cases of patients underwent endoscopic surgery through nasal cavity and lacrimal caruncle conjunctival incision,4cases received bone fracture reduction and DCR with endoscope through double path of nasal cavity and the original trauma wound,2cases with endoscopic bone tumor resection through nasal cavity and external nasal incision,the rest of the 3cases with endonasal endoscopic and peri-orbit incision surgery.Result：Two cases of tumor patients showed no recurrence followed up for 1.5to 2years;the diplopia disappeared in 2cases of orbital medial wall fracture;surgeries of 4cases of orbital wall fracture with lacrimal duct obstruction patients,3cases succeeded,1case failed and change into dacryocystorhinotomy with external nasal incision,and epiphora of all patients vanished;all of the patients of sinus osteoma,foreign bodies and abscess were cured and symptoms disappeared;the symptoms of ectopic meningioma patient gradually died down with eyebrow scars left.Conclusion：The surgery with external nasal incision combined with nasal cavity approach through endoscope to treat nose-eye correlated diseases can effectively deal with relevant pathological changes,with the advantages of clear operation field and less damage,but its exact indications and surgical methods still need to be further explored.

关 键 词：内镜外科手术 鼻眼相关性疾病 鼻窦 眼眶 

分 类 号：R765[医药卫生—耳鼻咽喉科]