中华神经外科杂志
中華神經外科雜誌
중화신경외과잡지
Chinese Journal of Neurosurgery
2014年
6期
582-585
,共4页
康军%付继第%史季桐%张家亮%周军%刘浩成%孙思%邱锷%杨澎
康軍%付繼第%史季桐%張傢亮%週軍%劉浩成%孫思%邱鍔%楊澎
강군%부계제%사계동%장가량%주군%류호성%손사%구악%양팽
内镜%颅底外科%眶尖病变
內鏡%顱底外科%眶尖病變
내경%로저외과%광첨병변
Endoscope%Skull base surgery%Orbital apex lesion
目的 探讨内镜下经鼻入路切除眶尖区占位病变的可行性和有效性.方法 回顾性分析2009年1月至2013年6月以突眼及视力下降为主要症状的18例眶尖区占位病变(6例眶内异物、4例海绵状血管瘤、3例鼻眶沟通性粘液囊肿、2例炎性假瘤、1例表皮样囊肿、1例神经纤维瘤、1例骨纤维异常增殖症).全部均在内镜下经鼻筛窦进入眼眶内或眶尖区切除病变.结果 眶内异物均一次性取出;4例眶尖区海绵状血管瘤全部切除,2例视力较术前好转,2例无变化;8例沟通性肿瘤4例全部切除,3例部分切除,术后眼球突出及活动障碍症状消失或明显好转.随访3个月至4年,2例炎性假瘤1例症状复发,再次手术后切除;其余病例均临床症状消失,无复发.结论 内镜下经鼻入路切除眶内及眶尖区占位病变是切实可行的.
目的 探討內鏡下經鼻入路切除眶尖區佔位病變的可行性和有效性.方法 迴顧性分析2009年1月至2013年6月以突眼及視力下降為主要癥狀的18例眶尖區佔位病變(6例眶內異物、4例海綿狀血管瘤、3例鼻眶溝通性粘液囊腫、2例炎性假瘤、1例錶皮樣囊腫、1例神經纖維瘤、1例骨纖維異常增殖癥).全部均在內鏡下經鼻篩竇進入眼眶內或眶尖區切除病變.結果 眶內異物均一次性取齣;4例眶尖區海綿狀血管瘤全部切除,2例視力較術前好轉,2例無變化;8例溝通性腫瘤4例全部切除,3例部分切除,術後眼毬突齣及活動障礙癥狀消失或明顯好轉.隨訪3箇月至4年,2例炎性假瘤1例癥狀複髮,再次手術後切除;其餘病例均臨床癥狀消失,無複髮.結論 內鏡下經鼻入路切除眶內及眶尖區佔位病變是切實可行的.
목적 탐토내경하경비입로절제광첨구점위병변적가행성화유효성.방법 회고성분석2009년1월지2013년6월이돌안급시력하강위주요증상적18례광첨구점위병변(6례광내이물、4례해면상혈관류、3례비광구통성점액낭종、2례염성가류、1례표피양낭종、1례신경섬유류、1례골섬유이상증식증).전부균재내경하경비사두진입안광내혹광첨구절제병변.결과 광내이물균일차성취출;4례광첨구해면상혈관류전부절제,2례시력교술전호전,2례무변화;8례구통성종류4례전부절제,3례부분절제,술후안구돌출급활동장애증상소실혹명현호전.수방3개월지4년,2례염성가류1례증상복발,재차수술후절제;기여병례균림상증상소실,무복발.결론 내경하경비입로절제광내급광첨구점위병변시절실가행적.
Objective To investigate the fcasibility and efficacy of resection of orbital apex lesions through transnasal endoscopic approach.Methods From January 2009 to June 2013,18 patients with orbital apex lesions were analyzed retrospectively,of which the main symptoms were proptosis and vision loss.In this series,6 cases were orbital foreign body,4 cavernous hemangioma,3 trans-nasal-orbital mucinous cyst,2 inflammatory pseudotumor,1 cholesteatoma,1 neurofibroma,and 1 fibrodysplasia.All the patients underwent operation through ethmoid sinus with endoscopic techniques into orbit or orbital apex.Results All the foreign bodies were taken out by one operation.4 cavernous hemangiomas in orbital apex were totally removed,in two of them the postoperative visions were improved and another two unchanged.In 8 trans-nasal-orbital tumors,4 were totally removed,3 partially removed,of which the proptosis and eyeball movement were improved.All the patients were followed-up from 3 months to 4 years.1 inflammatory pseudotumor recurred and was removed again.There was no recurrence in the rest of cases,and the symptoms were disappeared.Conclusions In carefully selected cases,the lesions in orbit and orbital apex could be removed feasibly through transnasal endoscopic approach.
