鼻窦黏液囊肿侵犯眼眶患者的临床观察  

Clinical observation of patients with paranasal sinus mucoceles involving the orbit

作　　者：胡汝平 王伟献 李巧银 王适 姚宁 Hu Ruping;Wang Weixian;Li Qiaoyin;Wang Shi;Yao Ning(Department of Ophthalmology,the Municipal First People′s Hospital of Zhumadian,Zhumadian 463000,China;Department of Otolaryngology,the Municipal First People′s Hospital of Zhumadian,Zhumadian 463000,China)

机构地区：[1]驻马店市第一人民医院眼科,驻马店463000 [2]驻马店市第一人民医院耳鼻喉科,驻马店463000

出　　处：《中华眼外伤职业眼病杂志》2024年第6期457-460,共4页Chinese Journal of Ocular Trauma and Occupational Eye Disease

摘　　要：目的观察累及眼眶的鼻窦黏液囊肿患者的临床特征、病理学结果及手术效果。方法回顾性病例系列研究。纳入驻马店市第一人民医院2017年1月至2023年8月累及眼眶的鼻窦黏液囊肿31例患者,均行鼻内镜鼻窦手术。分析其初始症状、就诊科室和症状持续时间等临床表现、CT特点和手术治疗等资料。分析术后病理组织学检查结果,确定黏液囊肿的类型。行眼部检查及鼻内镜检查,观察手术效果和黏液囊肿复发等情况。术后随访6个月至1.5年。结果本研究31例中以眼球突出为主要临床表现者23例(74.19%),其次为上睑下垂3例(9.68%),眶周肿物2例(6.45%),复视2例(6.45%)和头痛1例(3.23%)。初次就诊科室为眼科者27例(87.10%),3例(9.68%)为耳鼻喉科,1例(3.22%)为神经内科。病理检查结果证实均为单侧黏液囊肿,其中位于额窦18例(58.06%)、筛窦10例(32.26%)、额-筛窦黏液囊肿3例(9.68%)。30例(96.77%)的窦口引流通畅,1例(3.23%)复查时发现窦口瘢痕狭窄,经门诊处理后治愈。无黏液囊肿复发或泪道损伤等严重术后并发症发生。结论鼻窦黏液囊肿多累及额窦和筛窦,常以眼球突出为主要临床表现。应用鼻内镜手术能有效缓解症状,保持窦口通畅,并发症少。ObjectiveTo observe the clinical characteristics,pathology,and surgical outcomes of patients with paranasal sinus mucoceles involving the orbit.MethodsThis retrospective case series study reviewed 31 cases of paranasal sinus mucoceles with orbital involvement treated by endoscopic sinus surgery at a single institution from Jan.2017 to Aug.2023 in the Municipal First People′s Hospital of Zhumadian.The clinical manifestations,CT characteristics and surgical treatment of the patients,such as initial symptoms,consultation specialties and symptom duration,were collected.Postoperative pathology results were analyzed to determine the type and location of mucoceles.Surgical outcomes were assessed through follow-ups ranged from 6 months to 1.5 years,including ocular examination and nasal endoscopy,to evaluate sinus drainage and recurrence of mucoceles.The follow-up time was 6 months to 1.5 years.ResultsMost patients presented with proptosis in 23 cases(74.19%),followed by ptosis in 3 cases(9.68%),periorbital mass lesion in 2 cases(6.45%),diplopia in 2 cases(6.45%),and headache in 1 case(3.23%).The majority of initial consultations occurred in ophthalmology with 27 cases(87.10%),otolaryngology with 3 cases(9.68%),and neurology with 1 case(3.22%).Pathology results confirmed unilateral mucous cyst lesions,with predominantly 18 cases(58.06%)in the frontal sinus,10 cases(32.26%)in the ethmoid sinus,and 3 cases(9.68%)in the fronoethmoidal sinus.Postoperative follow-up showed successful unobstructed sinus drainage in 30 cases(96.77%).Only 1 case(3.23%)experienced scarring and narrowing of the sinus opening,which was effectively managed with outpatient procedures.There were no recurrences of mucoceles or serious postoperative complications.ConclusionParanasal sinus mucoceles predominantly affects the frontal and ethmoidal sinuses and commonly presents with proptosis.Surgical intervention,primarily via endoscopic approaches,is effective in resolving symptoms and ensuring unobstructed sinus drainage with minimal complications.

关 键 词：黏液囊肿 鼻窦 眼眶 眼球突出 手术 鼻内镜 窦腔 复发 

分 类 号：R779.6[医药卫生—眼科]