孤立性蝶窦疾病的诊断和治疗

The diagnosis and treatment of isolated sphenoid sinus disease

目的探讨孤立性蝶窦疾病的临床表现,提高首诊准确率,并寻求合适的治疗方法。方法22例术前均行CT或MRI和鼻内镜检查,术中取病变组织送病理明确诊断。结果经鼻内镜手术后随访5个月至两年半,22例症状明显好转,蝶窦前壁通畅,窦壁光滑。结论孤立性蝶窦疾病并非罕见,头痛是常见非特异性症状,可伴有视力下降等颅神经损害及血性涕等症状。鼻内镜手术是治疗本病的首选术式。

OBJECTIVE To evaluate clinical mani- festations of isolated sphenoid sinus disease to en- hance the accuracy of diagnosis and search for appro- priate treatment method.METHODS 22 patients with isolated sphenoid sinus disease who underwent endo- scopic sinus surgery were analysed.RESULTS The main clinical symptoms among 22 cases were as follows:headache in 19,hypopsia in 5,blindness in 1, exophthalmos in 1,sneezing with blood in 4 cases.15 isolated sphenoid sinusitis,2 fungal sphenoid sinusitis, 3 sphenoid mucocele and 2 sphenoid sinus carcinoma were found preoperatively by CT or MRI scan and nasal endoscopy. The diagnostic accuracy was 95.5 %.Post- operative endoscopy follow-up varied from 5 months to 2.5 years.All the patients were free from symptoms. The anterior wall of sphenoid sinus was open and the mucus in sphenoid cavity was smooth.CONCLUSION Isolated sphenoid sinus disease were not rare.Head- ache was the most common symptoms,it might be accompanied by some other symptoms such as hypopsia and sneezing with blood. CT or MRI scan and nasal endoscopy were accurate for diagnosis of the disease. Endoscopic sinus surgery was the first choice of treaetment for isolated sphenoid sinus disease. [