孤立性蝶窦病变70例临床特征分析

Clinical characteristics of 70 patients with isolated sphenoid sinus disease

目的分析孤立性蝶窦病变的临床特征。方法回顾分析2009年1月~2020年1月诊断的70例孤立性蝶窦病变病例的临床特征及诊治经过。结果70例病例中,真菌球型蝶窦炎24例、蝶窦囊肿17例、慢性蝶窦炎11例、变应性真菌性蝶窦炎6例、急性蝶窦炎5例、蝶窦息肉2例、脑脊液鼻漏(蝶窦)2例、蝶窦骨纤维异常增殖症1例、蝶窦内翻性乳头状瘤1例、蝶窦腺癌1例。其中55.7%病例以头痛为首发症状,67.14%病例在明确诊断前鼻内镜检查未发现阳性体征。总体病例发生误诊29例,误诊率为41.43%。结论孤立性蝶窦病变缺乏特异性临床症状和阳性体征,对于可疑病例进行内镜和影像学检查有助于诊断。

Objective To analyze the clinical characteristics and the process of diagnosis and treatment for isolated sphenoid sinus disease.Methods Data of 70 cases with isolated sphenoid sinus disease from January 2009 to January 2020 were analyzed retrospectively.Results In the 70 cases,there were 24 cases of fungus ball sphenoid sinusitis,17 cases of sphenoid sinus mucocele,11 cases of chronic sphenoiditis,6 cases of allergic fungal sphenoid sinusitis,5 cases of acute sphenoiditis,2 cases of sphenoid sinus polyp,2 cases of cerebrospinal rhinorrhea(sphenoid sinus),1 case of fibrous dysplasia of bone of sphenoid sinus,1 case of inverted papilloma of sphenoid sinus and 1 case of sphenoid sinus gland carcinoma.Headache was the first clinical symptom in 55.7%of the cases,67.14%of the cases had no positive signs before definite diagnosis.Twenty-nine cases were misdiagnosed,with a total misdiagnosis rate of 41.43%.Conclusions Isolated sphenoid sinus disease is lack of suggestive clinical symptoms and signs.Endoscopic and imaging examination are helpful to the diagnosis of isolated sphenoid sinus lesions for suspected cases.