鼻石症:使用橡胶聚乙烯支架的泪囊鼻腔吻合术出现的晚期并发症

To describe a rare case of rhinolith formation 21 years after dacryocystorhino stomy (DCR) with rubber gum and polyethylene tubing surgery. Interventional case report. A 23-year-old-woman underwent uneventful left DCR with rubber gum an d polyethylene tubing for chronic dacryocystitis. Twenty-one years later, she p resented with purulent rhinorrhea, nasal obstruction, and facial pain. Computed tomography revealed a radiopaque density in the left nasal cavity. A rubber gum foreign body embedded with granulation tissue and a huge rhinolith was removed e ndoscopically through the anterior nares. After surgery, the patient reported im mediate and complete relief of symptoms. Rhinoliths can develop progressively se veral years after DCR as a result of foreign body reaction to rubber gum or poly ethylene tubing. This rare complication should be ruled out in patients complain ing of purulent rhinorrhea who underwent DCR with tubing before the early 1980s.

6例鼻石症临床特征分析

1病例报告 2002-2013年间在我院就诊的6例鼻石患者中,男4例,女2例;年龄10~67岁。6例患者均有单侧鼻塞,3例伴有脓涕,2例为脓血涕,1例为鼻腔反复出血,2例伴有头痛。所有病例均否认有鼻腔异物史,1例儿童曾在外院诊断为鼻腔结石。前鼻镜检查,发现患侧鼻腔黏脓涕,鼻中隔向患侧不同程度偏曲4例。6例均行鼻内镜检查。麻黄素、丁卡因充分收缩麻醉鼻腔黏膜后,鼻内镜下吸净鼻腔黏脓涕探查,鼻腔中后段可见黄、灰、

真菌性鼻-鼻窦炎鼻石形成致鼻中隔穿孔1例并文献复习

目的通过分析1例真菌性鼻-鼻窦炎(FRS)鼻石形成致鼻中隔穿孔患者的临床资料,总结该疾病的诊疗方案,以提高对该病的认识。方法患者,男,55岁,因“反复嗅到臭味5年余,伴左侧头痛1周”入院,入院后完善影像学等相关检查,提示:FRS、鼻石症及鼻中隔穿孔,于全身麻醉鼻内镜下行左侧鼻窦开放+鼻腔肿块切除+鼻中隔修补术。结果患者手术顺利,术后第4天出院,术后随访半年,鼻中隔穿孔修补满意,鼻腔黏膜无水肿,各鼻窦开放口良好,鼻道及窦腔内均未见异常分泌物。至今未见复发。结论FRS鼻石形成致鼻中隔穿孔较少见,临床表现缺乏特异性,诊断主要依靠影像学检查及病理学检查,手术切除为主要治疗手段,术后有复发的可能,应注意随访。

鼻内镜下处理鼻石6例

鼻石,也叫鼻石病或鼻石症,是矿物盐类在鼻腔异物周围经数年的沉积而形成的块状物。作为鼻石核心的鼻腔异物有外源性和内源性之分：外源性异物以纽扣、小卵石、玻璃珠、棉絮、纸屑、植物种子、橡皮擦、布条等为核心（假性鼻石）;内源性异物则以血凝块、碎骨片、脱落上皮残骸、细菌、痂皮、异位牙、黏液等为其核心（真性鼻石）。