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目的:提高对孤立性蝶窦疾病的认识,以降低其误诊、漏诊的发生率。方法:分析22例孤立性蝶窦疾病患者的临床表现和鼻内镜治疗的优势。结果:12例行鼻内镜蝶窦开放术,7例行鼻外筛窦进路手术,3例行抗感染、激素、神经营养药等治疗,头痛症状全部消失,视力不同程度恢复。眼球运动障碍改善,随访3~6个月,1例症状复发,再次行鼻内镜手术后症状缓解。1例腺样囊性癌术后放疗,随访3年无复发。结论:以头痛和(或)眼部症状为主的孤立性蝶窦疾病,容易造成误诊、漏诊;CT、MRI和鼻内镜的应用,提高了对该病的诊疗水平;鼻内镜手术是治疗孤立性蝶窦疾病的首选。
Objective: To improve the understanding of solitary sphenoid sinus diseases to reduce the incidence of misdiagnosis and missed diagnosis. Methods: The clinical manifestations and the advantages of endoscopic treatment of 22 patients with solitary sphenoid sinus were analyzed. Results: 12 cases underwent open endoscopic endoscopic sinus surgery, 7 cases underwent extranodal ethmoid sinus surgery, and 3 cases were treated with anti-infective, hormone and neurotrophic drugs. All the symptoms of headache disappeared and visual acuity recovered to varying degrees. Eye movement disorders improved, followed up for 3 to 6 months, 1 case of recurrence of symptoms, again undergoing endoscopic sinus surgery to relieve symptoms. One case of adenoid cystic carcinoma postoperative radiotherapy, no follow-up of 3 years follow-up. Conclusion: Solitary sphenoid sinus diseases, which are mainly headache and / or ocular symptoms, are easy to cause misdiagnosis and misdiagnosis. The application of CT, MRI and endoscopy enhance the diagnosis and treatment of the disease. Endoscopic sinus surgery The treatment of solitary sphenoid sinus disease of choice.