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目的:探讨孤立性蝶窦疾病的临床特点和治疗方法,提高首诊准确率和治愈率,避免产生严重并发症。方法:回顾性分析46例孤立性蝶窦疾病患者的临床表现、影像学特点、病理类型和外科治疗效果。结果:本病主要症状为头痛和视力损害;影像学检查见蝶窦占位,部分可有骨质破坏;病理检查显示蝶窦炎症8例,真菌病19例,囊肿10例,息肉9例;全部患者经鼻内镜蝶窦开放手术。随访6个月以上,绝大部分患者症状明显好转,检查蝶窦开口通畅,窦腔无分泌物,窦壁光滑。结论:孤立性蝶窦疾病症状无特异性,鼻内镜和CT或MRI检查能提高术前诊断率,内镜鼻窦手术是治疗的首选术式。
Objective: To explore the clinical features and treatment of solitary sphenoid sinus disease, improve the accuracy and cure rate of first diagnosis and avoid serious complications. Methods: A retrospective analysis of 46 cases of solitary sphenoid sinus disease in patients with clinical manifestations, imaging features, pathological types and surgical treatment. Results: The main symptoms of the disease were headache and visual impairment. Sphenoid sinus space-occupying and some bone destruction were found in the imaging examination. Pathological examination revealed sphenoid sinusitis in 8 cases, mycosis in 19 cases, cysts in 10 cases and polyps in 9 cases. All patients underwent open endoscopic sinus surgery. Follow-up more than 6 months, the vast majority of patients with symptoms improved significantly, check the sphenoid sinus patency, sinus no secretions, sinus wall smooth. CONCLUSIONS: Solitary sphenoid sinus disease has no specific symptoms. Nasal endoscopy and CT or MRI can improve the preoperative diagnosis rate. Endoscopic sinus surgery is the first choice of treatment.