孤立性蝶窦占位性病变的诊断与治疗

Isolated sphenoid sinus disease

进一步认识孤立性蝶窦占位性病变，提高对其诊断和治疗水平。方法：在鼻内窥镜下摘除蝶窦囊肿２０例，行蝶窦探查术６例，经鼻外径路摘除囊肿３例，前颅底径路病变切除＋视神经减压术１例。结果：２４例随访０．５～４年无复发，１例术后不久囊肿复发，１例术后１年复发再次手术后随访１年无复发，１例正在放疗中，３例失访。结论：由于本病早期无独特症状，ＣＴ检查对诊断本病有较大价值，且对手术有一定指导意义；鼻内窥镜手术对治疗蝶窦良性占位性病变有显著的优越性。

Objective:The purpose of this study is to review isolated sphenoid sinus disease,to establish correct diagnosis and to treat it effectively in the future. Method: 26 patients underwent endoscopic surgery,in which20 sphenoid sinus mucocoeles were removed and 6 sphenoid sinuses were explored. 3 sphenoid sinus mucocoeleswere removed by external approach, 1 patient underwent skull base surgery and decompression of optic nerve. Result: 24 patients were free from disease postoperatively within 0. 5-4 years follow--up, 2 patiens underwent re--operation because of recurrence, lpatient was undergoing radiotherapy, 3 patients could not contact. Conclusion:This study shows that CT not only makes contribution to establish correct diagnosis but also plays an importantrole in surgery of isolated sphenoid sinus disease. Endoscopic surgery is valuable in treatment for benign diseaseof sphenoid sinus.