广州医药 ›› 2020, Vol. 51 ›› Issue (4): 55-58.DOI: 10.3969/j.issn.1000-8535.2020.04.012

• 论著 • 上一篇    下一篇

孤立性蝶窦病变的诊治分析

康晓明, 周芳   

  1. 南华大学附属长沙市中心医院(长沙 410000)
  • 收稿日期:2020-02-11 出版日期:2020-07-20 发布日期:2021-11-28
  • 通讯作者: 康晓明,E-mail:654352873@qq.com

Diagnosis and treatment of solitary sphenoid sinus disease

KANG Xiaoming, ZHOU Fang   

  1. Changsha Central Hospital,University of South China,Changsha 410000,China
  • Received:2020-02-11 Online:2020-07-20 Published:2021-11-28

摘要: 目的 通过分析孤立性蝶窦病变的临床特点,进一步提高早期诊断率及治疗疗效。方法 回顾性分析2019年1月—2019年8月在我科手术的孤立性蝶窦病变的9例患者临床资料,总结分析蝶窦病变的临床症状、鼻窦影像学表现及鼻内镜手术疗效。结果 蝶窦病变平均发病年龄约59.1岁,1例为双侧真菌性蝶窦炎,只有1例首诊于耳鼻喉科,8例患者就诊于神经内科,都以头痛为首发症状,1例鼻流清亮液体,鼻腔异味2例,鼻塞、脓涕1例,嗅觉功能减退1例。不同类型的蝶窦病变影像学表现不同,临床症状不同,绝大多数患者以头痛为首发症状。所有患者均在全身麻醉下行鼻内镜手术。术后随访至少3月以上,术后症状完全消失,无复发病例。结论 头痛是孤立性蝶窦病变最常见的临床特点,鼻窦影像学检查是重要的诊断手段,鼻内镜下经嗅裂蝶筛隐窝进路开放蝶窦是最有效的治疗手段。

关键词: 蝶窦病变, 影像学, 鼻内镜手术

Abstract: Objective By analyzing the clinical characteristics of solitary sphenoid sinus disease,the early diagnosis rate and therapeutic effect can be further improved. Methods The clinical data of 9 patients with isolated sphenoid sinus lesions operated on in our department from January 2019 to August 2019 were retrospectively analyzed,and the clinical symptoms,imaging features of the sinuses and the efficacy of nasal endoscopic surgery were summarized and analyzed. Results The average age of onset of sphenoid sinus lesions was 59.1 years old,1 case was bilateral fungal sphenoid sinusitis,only 1 case was first diagnosed in the department of otolaryngology,8 cases were treated in the department of neurology,all with headache as the first symptom,1 case had clear rhinorrhea,2 cases had nasal odor,1 case had nasal obstruction,1 case had purulent nose,and 1 case had anosmia. The imaging manifestations and clinical symptoms of different types of sphenoid sinus lesions were different,and headache was the first symptom of most patients. All patients underwent nasal endoscopic surgery under general anesthesia. The patients were followed up for at least 3 months after the operation,and the symptoms completely disappeared without recurrence. Conclusion Headache is the most common clinical feature of isolated sphenoid sinus lesions. Imaging examination of the sinus is an important diagnostic method,and endoscopic opening of the sphenoid sinus through the sphenoidal cleft via sphenoidal recess is the most effective treatment method.

Key words: Sphenoid sinus disease, Imaging, Endoscopic sinus surgery