鼻内镜下手术治疗伴视力减退的蝶筛窦囊肿(附11例报告)

Nasal Endoscopic Surgery for Sphenoidal and Ethmoidal Cysts with Visual Loss: a Report of 11 Cases

目的探讨鼻内镜手术治疗伴视力减退的蝶筛窦囊肿的疗效。方法2006年1月～2013年6月对11例蝶筛窦囊肿行鼻内镜下鼻腔鼻窦探查，鼻窦开放术，清除窦腔内囊肿，术后常规使用激素并定期随访。结果手术时间50～90min，平均65min；出血量50～100ml，平均60ml。11例术后病理：黏液囊肿。术后随访6—12个月，头痛、鼻根部疼痛基本消失。视力恢复情况：2例由术前眼前指数分别提高到0．3、0．5，其余9例恢复到发病前水平。结论鼻内镜手术治疗伴有视力减退的鼻窦囊肿疗效满意，及时手术是恢复视力的关键。

Objective To explore the clinical efficacy Qf sphenoidal and ethmoidal cysts with visual loss by nasal endoscopic surgery. Methods Eleven cases （ 11 eyes） of sphenoidal and ethmoidal cysts with visual impairment were reviewed retrospectively. The patients received endoscopic surgery to remove cysts. Steroid therapy was given postoperatively and routine examinations with endoscopy were carried out during the follow-up. Results The operation time was 50 - 90 min （ mean, 65 min） , and the intraoperative blood loss was 50 - 100 ml （mean, 60 ml）. Postoperative pathological examinations showed mucous cysts. Follow-up observations for 6 -12 months in the 11 cases found the majority of symptoms, such as pain in nose and headache, disappeared. The postoperative visual acuity outcomes were improved from fingers counting to 0.3 and 0.5 in 2 eyes, respectively, and recovered to premorbid level in 9 eyes. Conclusions Endoscopic surgery is effective to sphenoidal and ethmoidal cysts with visual loss. Prompt surgical intervention is crucial to visual recovery.