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目的 探讨经鼻内镜筛窦纸板进路手术治疗眶内各种疾病的可行性并确立临床处理的基本原则。方法 经鼻内镜进路眶内手术 10例 :眶内异物取出术 4例、球后海绵状血管瘤切除术 1例、眶内侵犯或转移的恶性肿瘤切除术 5例。结果 眶内异物取出术 3例成功 ,1例失败 ;球后海绵状血管瘤 1例完整切除 ;鼻咽癌眶内转移 1例手术切除 +放射治疗后随访 4年无复发 ,视力恢复至 0 6 ;其他眶内恶性肿瘤 4例 ,手术后随访 1～ 4年均健在。 10例手术后 1例视力损伤 ,9例均保留原有视力 ,其中 3例失明病例中 2例视力有一定程度的恢复。结论 位于视神经内侧的某些占位性病变可以经鼻内镜筛窦纸板进路完成。当代先进的放射治疗技术为眶内恶性肿瘤的保守性手术创造了条件
Objective To explore the feasibility of intranasal endoscopic sinus cardinal approach for the treatment of various diseases in the orbit and to establish the basic principles of clinical treatment. Methods Nasal endoscopic orbital surgery in 10 cases: intraorbital foreign body removal in 4 cases, 1 case of retrobulbar cavernous hemangioma resection, orbital invasion or metastases in 5 cases of malignant tumor resection. Results 3 cases of intraorbital foreign body removal were successful and 1 case failed. One case of posterior cavernous hemangioma was completely resected. One case of nasopharyngeal carcinoma orbital metastasis after surgical resection plus radiotherapy was followed up for 4 years without recurrence and visual acuity was restored to 0 6 ; Other intraorbital malignancies in 4 cases, followed up for 1 to 4 years after surgery are alive. One case had visual impairment after operation in 10 cases, and 9 cases had original visual acuity. The visual acuity of 2 cases in 3 cases of blindness recovered to a certain extent. Conclusion Certain space-occupying lesions located on the medial side of the optic nerve can be completed by endoscopic sinus cardinal approach. Contemporary advanced radiotherapy techniques create conditions for conservative surgery of orbital malignancies