孤立性蝶窦疾病的临床分析

Clinical analysis of solitary sphenoid sinus disease

目的:探讨孤立性蝶窦疾病的临床特点和治疗方法,提高首诊准确率和治愈率,避免产生严重并发症。方法:回顾性分析46例孤立性蝶窦疾病患者的临床表现、影像学特点、病理类型和外科治疗效果。结果:本病主要症状为头痛和视力损害;影像学检查见蝶窦占位,部分可有骨质破坏;病理检查显示蝶窦炎症8例,真菌病19例,囊肿10例,息肉9例;全部患者经鼻内镜蝶窦开放手术。随访6个月以上,绝大部分患者症状明显好转,检查蝶窦开口通畅,窦腔无分泌物,窦壁光滑。结论:孤立性蝶窦疾病症状无特异性,鼻内镜和CT或MRI检查能提高术前诊断率,内镜鼻窦手术是治疗的首选术式。

Objective：To explore the clinical characters and treatment on solitary sphenoidal sinus disease thus improve the initial diagnosis accuracy and curative rate together with avoiding severe complications. Method： Forty- six cases were included in the study. The clinical manifestations, medical imaging characteristics and type of pathology and surgical treatment efficacy were analyzed retrospectively. Result： The main symptoms were headache and visual lesion. Medical image showed pace occupying lesion and partial destruction of bone. Pathological exams showed 8 cases with sphenoiditis, 19 cases with fungal infection, 10 cases with cysts and 9 cases with polyposis. All the patients underwent open sphenoidal surgery with nasal endoscope. After a follow-up of over 6 months, most of the patients＇ symptoms had been obviously relieved. And the entrance to sphenoid was patent with smooth sinus wall and no secretion in sinus cavity. Conclusion： There is no specificity with solitary sphenoidal sinus disease. Pre-operation diagnosis rate can be improved with the help of nasal endoscope and CT or MRI. Nasal sinus surgery with nasal endoscope may be the first choice for treatment.