鼻内镜下鼻源性眶骨膜下脓肿的手术治疗观察

Transnasal endoscopic surgery for orbital subperiosteal abscess

目的 探讨鼻源性眶骨膜下脓肿的治疗方式及效果。方法 回顾分析11例于2015年11月~2020年2月在复旦大学附属眼耳鼻喉科医院接受鼻内镜手术治疗的眼眶骨膜下脓肿患者的临床资料,其中男性6例、女性5例,平均年龄为(36.5±5.4)岁。脓肿位置:额窦5例(45.4%)、筛窦4例(36.5%)、上颌窦2例(18.1%)。所有患者均接受鼻内镜下鼻窦引流术,其中3例同时接受内镜下鼻-眶联合手术。结果 所有患者术后眼部症状均减轻;随访6~12个月,均未见复发。结论 鼻内镜下鼻窦引流手术治疗眶骨膜下脓肿有效,若脓肿位于额窦外侧,超越眶中线,可行鼻-眶联合引流手术。

Objective To investigate the treatment and its effect on nasogenic orbital subperiosteal abscess. Methods Data of 11 patients(six men and five women, with an average age of 36.5±5.4 years) with orbital subperiosteal abscess treated with transnasal endoscopic surgery in the Eye & ENT Hospital of Fudan University from November 2015 to February 2020 were analyzed retrospectively. The lesions were located in frontal sinus in five patients(45.4%), ethmoid sinus in four cases(36.5%) and maxillary sinus in two cases(18.1%). All patients underwent endoscopic sinus drainage and three of which underwent endoscopic nasalorbital combination surgery simutaneously. Results All patients were followed up for 6 to 12 months,the ocular symptoms were reduced and no recurrence was observed. Conclusions Transnasal endoscopic sinus drainage surgery is an effective method for treating orbital subperiosteal abscess. If the abscess is located in the lateral frontal sinus, beyond the orbital midline, a combined naso-orbital drainage is feasible.