鼻中隔后端巨大囊肿1例

One case of huge cyst at the back end of nasal septum

患者，男，17岁，双鼻塞半年伴张口呼吸，持续性进行性加重，偶有头部胀痛，无耳部症状。体检：鼻中隔左偏，双鼻腔下鼻甲肥大，双鼻腔通畅。纤维鼻咽镜：巨大球形光滑淡红色新生物位于鼻咽顶后壁及鼻腔后端，大小约3．5cm×2．5cm，堵塞整个后鼻孔，新生物与双侧圆枕相贴（图1）。

A male of 17 years old complained of bilateral nasal congestion with mouth breathing for half a year. The physical examination showed patency of bilateral nasal cavity. Nasopharyngeal- fiberscope revealed a huge spherical smooth reddish mass at the nasopharyngeal posterior wall and the back-end of nasal cavity blocking the entire postnaris and contacting with bilateral tubal tori, the size of which is about 3.5 cm× 2.5 cm. The naso- pharyngeal 3D-CT showed a low density cystic mass area in the nasopharynx with smooth edges, and the CT value is approximately 32.4 HU. No exact enhancement was observed. The cystic mass originated from and compressed the back end of nasal septum. A semicircular defect in the leading edge of clivus was observed, and the inferior wall of sphenoid sinus is compressed uplifted upwards. The nasopharyngeal MR showed that the nasopharyngeal lesion presented short T1 and long T2 signals with multiple small wall nodules around. Neither the lesion nor the peripheral nodules can be significantly enhanced by enhancement scan. After a nasal endoscopic surgery, the case was definitely diagnosed as nasal septum back-end huge cyst.