巨大泡性中鼻甲脓囊肿伴眼眶侵犯1例并文献复习

Massive concha bullosa pyocele with orbital extention-A case report and review of the literature

目的:提高对泡性中鼻甲的临床认识。方法:报道1例伴眼眶侵犯的巨大泡性中鼻甲黏液脓囊肿患者的临床资料、手术方法及术后6个月的随访结果,对泡性中鼻甲的常见病变及相关问题进行文献复习。结果:泡性鼻甲发生黏液囊肿时常表现为中鼻甲呈球形膨大,可占据周围间隙并引起骨质压迫吸收,导致眼球移位甚至严重眼部并发症,鼻内镜下手术治疗有较好疗效。结论:泡性中鼻甲是中鼻甲常见解剖变异,较大时可引起周围组织阻塞性病变,其本身也可发生黏液囊肿及息肉等病变,黏液囊肿并发感染可形成脓囊肿,囊肿向四周膨大,可引起眼部并发症甚至颅内并发症,其发展过程一般较缓慢,及时的鼻内镜下手术对该病有良好疗效。

Objective ： To discuss the complication of common anatomic variant of the middle turbinate-concha bullosa. Method：We present a 35 years old man with inner canthus proptosis and orbital pain who was diagnosed to be a pyocele originated from concha bullosa by CT and operation. Resuit：Concha bullosa can develop to a pyocele. Direct extension of the mass from the nose into the orbit may occur. Good therapeutic effect was obtained by endo- scopic operation. Conclusion：Concha bullosa can result in obstruction of middle meatus and lead to sinusitis. Polyps or mucocele may also occur to Concha bullosa itself. Pyocele of concha bullosa can develop to such a massive extent that it leads to orbital complication. Endoscopic operation is best treatment to this disesase.