导航引导下鼻内镜经蝶筛入路眶尖部海绵状血管瘤摘除术的临床疗效观察  

Navigation-guided nasal endoscopy for removal of the cavernous hemangioma of the orbital apex through the sphenoid approach

作　　者：王耀华[1] 余进海 胡军华[1,2] 徐柒华 黄琴[1] 甘莆英[1] 王安安 廖洪斐[1] Wang Yaohua;Yu Jinhai;Hu Junhua;Xu Qihua;Huang Qin;Gan Puying;Wang An′an;Liao Hongfei(Department of Orbital Diseases,Ophthalmology Hospital Affiliated to Nanchang University,Nanchang 330006,China;Department of Ophthalmology,People's Hospital ofXinyu City,Xinyu 338099,Jiangxi Province,China)

机构地区：[1]南昌大学附属眼科医院眼眶病科,330006 [2]江西省新余市人民医院眼科,338099

出　　处：《中华眼科杂志》2021年第11期837-843,共7页Chinese Journal of Ophthalmology

基　　金：国家自然科学基金(82060181);江西省重点研发计划(20181BBG70007);江西省卫健委新技术推广计划(20195321)。

摘　　要：目的探讨导航引导下鼻内镜经蝶筛入路摘除眶尖部海绵状血管瘤的可行性。方法回顾性系列病例研究。收集2012年5月至2019年12月在南昌大学附属眼科医院就诊的影像学表现为眶尖部海绵状血管瘤并行导航引导下鼻内镜经蝶筛入路眶尖部海绵状血管瘤摘除术(附视频)的12例(12只眼)患者临床资料, 其中男性3例, 女性9例, 年龄32~59岁。分析患者术前、术后视功能变化及术后并发症情况。结果 3例术前视功能无损伤患者, 术后视功能仍然正常。其余9例患者术前均有视功能损伤, 其中3例术后视功能完全恢复正常, 2例视功能较术前有所改善, 4例术后视功能无变化。12例患者中3例患者无并发症发生, 9例患者术后出现短暂的眼球内转轻度受限伴复视症状, 均在术后1个月内完全恢复正常。结论导航引导下鼻内镜经蝶筛入路眶尖部海绵状血管瘤摘除术是一种有效可行的手术方法。Objective To explore the feasibility of navigation-guided nasal endoscopy for removal of the cavernous hemangioma of the orbital apex through the sphenoid approach.Methods Retrospective case series study.From May 2012 to December 2019,12 patients(12 eyes)with imaging findings of cavernous hemangioma in the orbital apex were collected at the Eye Hospital Affiliated to Nanchang University,including 3 males and 9 females aged 32 to 59 years.All patients underwent navigation-guided sinusoscopy through the sphenoid approach to remove the cavernous hemangioma of the orbital apex(video attached).Changes of visual function and complications after operation were analyzed.Results In 3 patients without visual impairment,the postoperative visual function was still normal.Among the remaining 9 patients with preoperative visual impairment,visual function was fully recovered in 3 patients after operation,was improved in 2 patients,and had no change in 4 patients.There were no complications in 3 of the 12 patients,and 9 patients had transient,mildly limited intraocular rotation with diplopia after operation,which all returned to normal within 1 month.Conclusion Navigation-guided sinus endoscopy through the sphenoid approach is effective and feasible in the removal of the cavernous hemangioma of the orbital apex.

关 键 词：眶肿瘤 血管瘤 海绵状 内窥镜检查 鼻外科手术 外科手术 计算机辅助 

分 类 号：R739.7[医药卫生—肿瘤]