鼻内镜及内眦联合进路切除巨大筛窦骨瘤1例  

Removal of a giant ethmoidal sinus osteoma with orbital extension

作　　者：白伟良[1] 柴广睿[2] 周倩[1] 李进兴 项清华 李婷[1] 刘天聪[1] 

机构地区：[1]中国医科大学附属盛京医院耳鼻咽喉科,沈阳110004 [2]中国医科大学附属盛京医院眼科

出　　处：《临床耳鼻咽喉头颈外科杂志》2017年第24期1932-1934,共3页Journal of Clinical Otorhinolaryngology Head And Neck Surgery

基　　金：辽宁省科学事业公益研究基金(No:2013001010);沈阳市科学计划项目资助(No:F11-264-1-07;F13-220-9-21)

摘　　要：筛窦骨瘤通常没有症状,往往偶然在影像片中发现。小的骨瘤不用处理,可定期观察;有临床症状、大的鼻窦骨瘤需要外科手术切除[1-2]。我科收治1例侵犯眼眶内的巨大筛窦骨瘤,经鼻内镜联合眼内眦进路手术成功切除,现报告如下1病例报告患者,男,65岁,以复视及左侧眼部周围疼痛1个月来我院诊治。查体可见双侧眼球运动正常,Osteomas are slow growing bony tumors of the nasal sinuses.Ethmoid osteomas with orbital extension are unusual.Any surgical approach has to take into account protection of the vital structures,particularly the optic nerve and internal rectus muscle,skull base.A 65-year-old man,without past medical history,was referred to our hospital with a 1-month history of double vision and persisting pain around the left eye.Three-dimensional computed tomography（CT）revealed a large calcified dense mass measuring 32 mm×25 mm ×25 mm in the left ethmoidal sinus with orbital extension.An endoscopic endonasal approach combined with inner canthus way was planned.Most of the tumor was removed from nasal cavity,the rest part of the tumor was taken out of the inner canthus incision.The medial wall of the orbital cavity was repaired with titanium mesh.No cerebrospinalfluid（CSF）leakage was observed during the procedure.The patient recovered rapidly and had no visual impairment and occular motility disorders after operation.The double vision was alleviated and disappeared after one months.Treatment of large ethmoid osteomas requires a combined approach to prevent injury to the orbital content.The cooperation of both otolaryngologists and ophthalmologists is necessary to achieve risk-free surgery.

关 键 词：骨瘤 筛窦 内镜外科手术 

分 类 号：R739.62[医药卫生—肿瘤]