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目的 :提高对孤立性蝶窦炎性疾病症状、体征的认识和首诊准确率。方法 :分析 4 9例孤立性蝶窦炎性疾病的临床表现 ,比较非内窥镜手术 10例和内窥镜手术 39例的手术效果。结果 :未经鼻窦内窥镜手术者 ,1例行蝶窦灌洗后头痛立即缓解 ,4例症状在 1周内缓解 ,5例 2～ 4个月后症状复发 ,窦口瘢痕狭窄阻塞 ,需手术切开引流。经鼻窦内窥镜蝶窦开放术者 ,治愈 31例 ,其中 10例手术后症状立即消失 ,2 1例术后 3～ 5d症状缓解 ;好转 8例 ,其中 5例仅感轻微头痛和嗅觉失灵 ,鼻内窥镜见窦口粘膜肿胀 ,CT、MRI复查未见窦腔病变 ;3例术后2个月视力恢复。术后 1个月复诊窦口开放率为 87.2 %。随访 6～ 4 8个月无病变及症状复发 ,未再次手术。结论 :孤立性蝶窦炎经CT或MRI等高清晰度的影像学检查加之以鼻窦内窥镜检查均可明确诊断 ,且经鼻窦内窥镜手术对其治愈有显著的优越性
Objective: To improve the diagnosis of solitary sphenoid sinusitis symptoms and signs of the first diagnosis and accuracy. Methods: The clinical manifestations of 49 cases of solitary sphenoid sinusitis were analyzed. The surgical results of 10 cases of non-endoscopic surgery and 39 cases of endoscopic surgery were compared. Results: Without endoscopic sinus surgery, 1 patient underwent splenectomy immediately relieved headache, 4 patients in 1 week to ease the symptoms, 5 patients 2 to 4 months after the recurrence of symptoms, sinus osseous stenosis, need to be Surgery incision and drainage. Transnasal endoscopic sphenoid sinus open surgery were cured in 31 cases, of which 10 cases disappeared immediately after surgery, 21 cases 3 to 5 days postoperative symptoms were relieved; improved in 8 cases, of which 5 cases only mild headache and sense of smell failure, Nasal endoscopic sinus mucosal swelling seen, CT, MRI no sinus lesions were reviewed; visual acuity was restored in 3 cases 2 months after surgery. One month after operation, the open rate of sinus ostium was 87.2%. Follow-up 6 ~ 48 months without disease and recurrence of symptoms, no reoperation. Conclusion: Solitary sphenoid sinusitis can be diagnosed by high-resolution CT or MRI combined with sinus endoscopy, and has obvious advantages in the treatment of solitary sphenoid sinusitis by endoscopic sinus surgery