孤立性蝶窦疾病159例临床分析

Isolated sphenoid sinus disease: a clinical analysis of 159 cases

目的:分析孤立性蝶窦疾病的诊断与治疗方法,使其得到早期诊断、及时干预和治疗,以降低误诊率。方法:对159例孤立性蝶窦疾病患者进行回顾性分析。结果:孤立性蝶窦疾病患者最常见的临床症状是头痛(79.87%,127/159)。在159例患者中,60例(37.74%)为蝶窦囊肿,44例(27.67%)为单纯性蝶窦炎,31例(19.50%)为真菌性蝶窦炎,5例(3.14%)为蝶窦息肉,3例(1.89%)为骨纤维异常增殖症,2例(1.26%)为内翻性乳头状瘤,3例(1.89%)为脊索瘤,3例(1.89%)为鳞状细胞癌,3例(1.89%)为恶性淋巴瘤,2例(1.26%)为神经内分泌癌,2例(1.26%)为嗅神经母细胞瘤,1例(0.63%)为恶性纤维组织细胞瘤。术后随访10个月～4年,鼻内镜术后多数患者转归良好。结论:孤立性蝶窦疾病常无特异性症状及体征,最常见的临床症状是头痛,其次是视力障碍,鼻内镜下蝶窦开放术是首选的治疗方法。

Objective：Aimed to observe and analyse the diagnostic and therapeutic methods of the isolated sphenoid sinus disease,achieve earlier diagnosis and timelier intervention for this easily neglected disease and decrease the occurrence of misdiagnoses.Method：A retrospective study was conducted in 159 patients with isolated sphenoid sinus disease.Result：Headache was the most common presenting symptom（79.87%,127/159）.Among the 159 cases,60（37.74%）had mucocele,44（27.67%） isolated sphenoiditis,31（19.50%） fungal sinusitis,5（3.14%） polyp,3（1.89%） fibrous dysplasia,2（1.26%） inverted papilloma,3（1.89%） chordoma,3（1.89%） squamous carcinoma,3（1.89%） malignant lymphoma,2（1.26%） neuroendocrine carcinoma,2（1.26%） olfactory neuroblastoma,and 1（0.63%） malignant fibrohistiocytoma.A follow-up of 10 months to 4 years post-surgery showed good prognosis in most of the patients who underwent surgical therapy.Conclusion：The sphenoid sinus di-sease is often vague and nonspecific in its clinical presentation.The most common clinical symptom is headache,followed by vision changes.Endoscopic sphenoidotomy is the primary therapy for isolated sphenoid sinus disease.