鼻内镜治疗巨大蝶、筛窦囊肿侵犯颅底7例临床分析

Therapeutic Endoscopy for Seven Macrosis Sphenoidal and Ethmoidal Cysts Encroaching on Basis Cranii

目的探讨鼻内镜治疗巨大蝶、筛窦囊肿侵犯颅底的方法.方法自从2000年1月至2009年6月,收治的7例巨大蝶、筛窦囊肿,均有侵犯颅底、联合耳鼻喉科在内窥镜下切除囊肿,并用鼻自体材料进行颅底重建修补.结果7例头痛,鼻塞症状均改善,术后1周眼球均恢复正常位置,眼球突出度恢复正常,视力不同程度恢复,复视消失,所有患者术后无颅内感染、脑膜脑膨出、脑疝等并发症,随访6个月～6a,其中2a以上者5例.1例自发性脑脊液鼻漏患者于术后2a再次出现脑脊液鼻漏,经保守治疗后治愈;1例经鼻内镜再次修补手术治愈;其余患者均一次性手术成功,未出现脑脊液鼻漏.结论鼻内窥镜手术治疗蝶、筛窦囊肿仍不失为一种安全有效的方法.

Objective To explore an approach of therapeutic endoscopy for macrosis sphenoidal and ethmoidal cyst encroaehing on skull base. Method 7 patients with macroais sphenoidal and ethmoidal cysts admitted from 2000 to 2009 in our hospital, all of encroaching on skull base, We and ENT doctors reseeied cysts in the endoscopy, and used nasal autologous material to reconstruct the skull base. The clinical data and evaluating the efficacy of the method were reported. Results Headache, stuffy nose symptoms in 7 patients were improved after 1 week. All eyes returned to normal position, exophthalmos returned to normal, varying degrees of vision recovery, diplopia disappeared in all patients,No postoperative intracranial infection, meningoencephalocele and other complications. Followed up for 6 months to 6 years, over 2 years in 5 cases. One cases of spontaneous CSF rhinorrhea were reported after 2 years, but one ease was cured by conservative treatment; the other was cured by endoscopic repair again; the remaining patients were successful. Conclusion Therapeutic endoscopy for sphenoidal and ethmoidal cyst is still regarded as a safe and effective method.