内镜经鼻海绵窦病变活检术

Endoscopic transnasal biopsy for diagnosis of cavernous sinus lesions

目的探讨内镜经鼻海绵窦病变活检术的外科技术。方法回顾性分析10例海绵窦病变采用内镜经鼻入路进行外科手术的临床资料。结果所有病人均明确诊断，其中脑膜瘤1例及鳞状细胞癌2例、上皮性癌、鳞状细胞癌、小细胞恶性肿瘤、霉菌性肉芽肿、神经鞘瘤、骨巨细胞瘤、嗅神经母细胞瘤各1例。术后5例恶性肿瘤患者进行放射治疗，1例脑膜瘤患者行γ-刀治疗，1例进行了抗真菌治疗，其余2例良性病变及1例已行局部放疗者随诊观察。并发症包括1例颈内动脉损伤，经介入手术行球囊栓塞术而治愈，1例短暂性脑脊液鼻漏。无感染及死亡病例。结论内镜经鼻入路是海绵窦区病变诊断的一种安全、有效、微创的外科方法。

Objective To study the surgical technique of endoscopic transnasal biopsy for the diagnosis of cavernous sinus lesions. Methods Ten patients with cavernous sinus lesions were diagnosed by endoscopic transnasal biopsy. Retrospectively the clinical data of 10 patients were reviewed. Results The accuracy of diagnosis with this technique was 100% . Postoperative results included： 5 patients with malignant tumors received radiotherapy, I patient with meningioma underwent γknife treatment, and 1 patient received antifungal therapy, 2 patients with benign lesion and 1 patient underwent local radiotherapy were followed. Postoperative complications included： one patient with internal carotid artery injury was treated by interventional ballon occlusion and one with transient cerebrospinal leakage. Condusion Endoscopic transnasal biopsy is an effective, safe and mini-invasive approach for the diagnosis of cavernous sinus lesions.