鼻内镜下筛窦骨瘤切除15例临床分析  

Endoscopic resection of ethmoid sinus osteoma:Clinical analysis of 15 cases

作　　者：黄喜 陈雨 陈沛[1] 刘卫红[1] 李春丽[1] 姚琳莉[1] HUANG Xi;CHEN Yu;CHEN Pei;LIU Weihong;LI Chunli;YAO Linli(Department of Otorhinolaryngology Head and Neck Surgery,First Hospital of Wuhan,Wuhan 430022,China;Huazhong University of Science and Technology,Wuhan 430022,China)

机构地区：[1]武汉市第一医院耳鼻咽喉头颈外科,湖北武汉430022 [2]华中科技大学,湖北武汉430022

出　　处：《中国耳鼻咽喉颅底外科杂志》2023年第4期86-90,共5页Chinese Journal of Otorhinolaryngology-skull Base Surgery

基　　金：武汉市2020年应用基础前沿项目(2020020601012310);武汉市卫健委2019年科研项目面上项目(WX19C07)。

摘　　要：目的报告鼻内镜下筛窦骨瘤切除15例,探讨鼻内镜下筛窦骨瘤切除的手术方法及治疗效果,总结鼻窦骨瘤的手术经验。方法回顾性分析武汉市第一医院耳鼻咽喉头颈外科2018年6月—2022年4月行鼻内镜下筛窦骨瘤切除术的15例患者的临床资料,所有患者术前均行鼻窦CT检查、鼻内镜检查、鼻阻力检查及眼科相关检查。手术均于全身麻醉鼻内镜下完成,根据CT确定筛窦骨瘤的位置和范围后确定具体的手术方式,完整切除筛窦骨瘤,术后门诊定期复诊,复查鼻窦CT、鼻内镜。结果15例患者术后病理均证实为筛窦骨瘤,鼻窦CT显示筛窦骨瘤均彻底切除,随访5~48个月,患者术后鼻塞、面部胀痛、头痛、流脓涕、嗅觉减退等症状较术前减轻或消失,未发生明显眶内、颅内并发症,未见骨瘤复发。结论术前鼻窦CT可确定骨瘤位置及范围,为鼻内镜手术提供良好保障,鼻内镜下筛窦骨瘤切除有效、安全、微创,预后良好,值得临床推广应用。Objective To report 15 cases of endoscopic resection of ethmoid sinus osteoma,to discuss the surgical method and treatment effect of endoscopic resection of ethmoid sinus osteoma,and to summarize the surgical experience of sinus osteoma.Methods The clinical data of 15 patients were retrospectively analyzed,who underwent endoscopic resection of ethmoid sinus osteoma in Department of Otolaryngology Head and Neck Surgery,Wuhan First Hospital from June 2018 to April 2022.All patients underwent paranasal sinus CT examination,nasal endoscopy,nasal resistance examination and ophthalmology related examinations before surgery.All operations were completed by nasal endoscopy under general anesthesia.The specific operation method was determined after the location and scope of ethmoid sinus osteoma were determined according to CT.The ethmoid sinus osteoma was completely removed.After the operation,postoperative patients were reexaminated by the nasal sinus CT and nasal endoscopy,and returned to the outpatient department regularly.Results All of the 15 patients were pathologically confirmed as ethmoid sinus osteoma after operation.CT of the sinus showed that ethmoid sinus osteoma was completely removed.After 5 to 48 months of follow-up,the symptoms of nasal congestion,facial swelling and pain,headache,purulent discharge and hypoesthesia were alleviated or disappeared after operation.No significant intraorbital and intracranial complications occurred,and no recurrence of osteoma was observed.Conclusions Nasal sinus CT can determine the location and scope of osteoma before operation,which provides a good guarantee for endoscopic sinus surgery.Endoscopic resection of ethmoid sinus osteoma is worthy of clinical application.It is effective,safe and minimally invasive,which has a good prognosis.

关 键 词：筛窦骨瘤 鼻内镜手术 预后 

分 类 号：R765.9[医药卫生—耳鼻咽喉科]