孤立性蝶窦病变的诊治体会

目的提高对孤立性蝶窦病变的诊断率和治疗率。方法回顾性分析2005年12月～2010年12月收治的15例孤立性蝶窦病变患者的临床表现、影像学特点、鼻内镜检特点以及鼻内镜手术治疗效果。结果蝶窦病变最主要的临床症状为头痛,鼻部症状并不典型。经影像学及鼻内镜检可确诊为孤立性蝶窦病变。经鼻内镜手术并随访6个月至3年,15例患者中1例复发,其余获治愈,治愈率达93.3%。复发患者经再次手术后获治愈。结论孤立性蝶窦病变临床症状无特异性表现,临床医师对该病认识不足是导致误诊的主要原因。CT、MRI和鼻内窥镜检查提高了对个孤立性蝶窦病变的诊断水平,经鼻内镜蝶窦手术治疗孤立性蝶窦病变可获得良好的效果。

Objective To correctly diagnose and treat isolated sphenoid sinus disease. Methods Cinical representation,imaging features,endoscopic features and endoscopic surgical effects of 15 cases with isolated sphenoid sinus diseases from Dec. 2005 to Dec. 2010 in our department were retrospectively analyzed. Results The main clinical symptom of isolated sphenoid sinus disease was headache,and the nasal symptom was rarely typical. Imaging and endoscopic examinations were helpful in diagnosis of the disease. In the follow up from 6 months to 3 years,14 cases were cured and the cure rate was 93.3%,and the other one suffered recurrence and was cured by re-operation. Conclusion Isolated sphenoid sinus disease is difficult to be diagnosed because of its non-specific symptoms. Lack of understanding of the disease is a main reason that induces the misdiagnosis of the isolated sphenoid sinus lesions. CT,MRI and endoscopic examinations can improve the diagnostic level of the isolated sphenoid sinus lesion and endoscope sinus surgery is valuable in diagnosis and treatment of isolated sphenoid sinus disease.