经鼻内镜联合右侧眉弓入路治疗右侧额筛窦骨纤维异常增殖症1例并文献复习  

A case of right frontal ethmoid sinus bone fibrous dysplasia treated by nasal endoscopy combined with right eyebrow arch approach and literature review

作　　者：蒋劲松[1] 赵汉飞 黄辉[1] 柴伟[1] 孙敬武 JIANG Jinsong;ZHAO Hanfei;HUANG Hui;CHAI Wei;SUN Jingwu(Department of Otolaryngology Head and Neck Surgery,Bozhou People’s Hospital,Bozhou,Anhui 236804,China;Department of Otolaryngology Head and Neck Surgery,The First Affiliated Hospital of University of Science and Technology of China,Hefei,Anhui 230032,China)

机构地区：[1]亳州市人民医院耳鼻咽喉头颈外科,安徽亳州236804 [2]中国科学技术大学附属第一医院耳鼻咽喉头颈外科,安徽合肥230032

出　　处：《安徽医药》2020年第3期548-550,I0007,共4页Anhui Medical and Pharmaceutical Journal

摘　　要：目的探讨鼻腔鼻窦骨纤维异常增殖症的治疗方法。方法总结亳州市人民医院2018年5月收治的1例右侧额筛窦骨纤维异常增殖症的临床资料,包括其病史、影像学资料、术中术后情况以及治疗经过。结果病人以头痛1年余、伴右眼胀痛不适半年入院,CT影像诊断为右侧额窦、筛窦区异常密度灶⁃考虑偏良性病变,骨纤维结构发育不良可能,请结合临床;鼻中隔偏曲,双侧下鼻甲肥大。MRI平扫+增强影像诊断为右侧筛窦、额窦窦腔内及右侧眶上壁异常信号,考虑骨瘤,不除外骨纤维异常增殖症或骨化纤维瘤,请结合临床;鼻中隔偏曲。行经鼻内镜联合右侧眉弓入路治疗,彻底切除鼻窦病变组织,手术顺利。术后病理检查示(右侧额筛窦)镜检骨小梁不规则,间质为纤维结缔组织。术后病人临床症状消失。随访半年无复发。结论采取经鼻腔及右侧眉弓联合径路,可以彻底切除鼻窦病灶,具有视野清晰、微创性、恢复快等特点,值得临床应用推广。Objective To explore the treatment of abnormal hypertrophy of bone fibers in nasal cavity and paranasal sinus.Methods The clinical data of a case of right frontal ethmoidal sinus osteo fibrodysplasia admitted to Bozhou People’s Hospital in May 2018 was summarized,including its history,imaging data,intraoperative and postoperative conditions and treatment.Results The patient was hospitalized with headache for more than one year and pain and discomfort of right eye for half a year.The CT image was diagnosed as follows:abnormal density foci in the right frontal sinus and ethmoid sinus area.,considering osteoma,excluding abnormal proliferation of bone fiber or ossifying fibroma,please combine with clinical;Curved,bilateral inferior turbinate hypertrophy.MRI plain scan and enhanced imaging diagnosis was as follows:abnormal signals in the right ethmoid sinus,frontal sinus cavity,and right upper orbital wall.Consider osteoma,without exclusion of osteofibrosis or ossifying fibroma,please combine with clinic.The patients were treated by transnasal endoscopy combined with right eyebrow arch approach,and the pathological tissue of paranasal sinuses was completely removed.The pathological examination showed that the trabeculae were irregular and the interstitium was fibrous connective tissue.The clinical symptoms disappeared after operation.Followup for half a year showed no recurrence.Conclusion By the combined approach of nasal cavity and right eyebrow arch,the sinus lesions can be completely resected,with clear vision,minimally invasive,rapid recovery and other characteristics.It is worthy of clinical application.

关 键 词：骨纤维发育不良 自然腔道内镜手术 眉弓入路 鼻内镜 

分 类 号：R765.9[医药卫生—耳鼻咽喉科]