经鼻内镜筛窦纸板进路眶内手术  

Orbital surgery by transnasal endoscopic ethmoidal-lamina papyracea approach

作　　者：许庚[1] 李源[1] 谢民强[1] 史剑波[1] 陈合新[1] 文卫平[1] 张革化[1] 刘贤[1] 徐睿[1] 吕剑霆[1] 

机构地区：[1]中山大学附属第三医院耳鼻咽喉科,广州510630

出　　处：《中华耳鼻咽喉科杂志》2002年第5期360-362,共3页Chinese Journal of Otorhinolaryngology

基　　金：国家自然科学基金委国家杰出青年基金课题( 970 2 5 0 2 5 )

摘　　要：目的　探讨经鼻内镜筛窦纸板进路手术治疗眶内各种疾病的可行性并确立临床处理的基本原则。方法　经鼻内镜进路眶内手术 10例 :眶内异物取出术 4例、球后海绵状血管瘤切除术 1例、眶内侵犯或转移的恶性肿瘤切除术 5例。结果　眶内异物取出术 3例成功 ,1例失败 ;球后海绵状血管瘤 1例完整切除 ;鼻咽癌眶内转移 1例手术切除 +放射治疗后随访 4年无复发 ,视力恢复至 0 6 ;其他眶内恶性肿瘤 4例 ,手术后随访 1～ 4年均健在。 10例手术后 1例视力损伤 ,9例均保留原有视力 ,其中 3例失明病例中 2例视力有一定程度的恢复。结论　位于视神经内侧的某些占位性病变可以经鼻内镜筛窦纸板进路完成。Objective To explore the feasibility of transnasal endoscopic surgery to treat some kinds of diseases within orbit by ethmoidal-lamina papyracea approach, and put forward the basic principle of surgical management. Methods A total of 10 cases undergone the endoorbital operation by transnasal endoscopic ethmoidal-lamina papyracea approach, including foreign body 4 cases, sponge haemangioma 1 case,invaded and metastatic carcinoma 5 cases. Results Successful removing of foreign body from endoorbital for 3 cases, and 1 failure. One case of sponge haemangioma was removed completely. One case of metastatic tumour from nasopharyngeal carcinoma was resected, with no relapse and vision recovered to 0.6 during follow-up period of 4 years. Four cases of invaded carcinoma from ethmosphenoidal sinus were resected completely. Followe- up for 1-4 years showed no relapse. Conclusion The endoorbital region inside the optic nerve can be controlled by transnasal endoscopic ethmoidal-lamina papyracea approach. The advanced radiotherapy provides favourable conditions for conservative surgery of endoorbital carcinoma.

关 键 词：经鼻内镜筛窦纸板进路 眶内手术 SURGICAL procedures endoscopic 

分 类 号：R765.9[医药卫生—耳鼻咽喉科]