以失明为首发症状的后组鼻窦囊肿3例及文献复习

Posterior sinus cyst with blindness as the first symptom: a report of 3 cases with literature review

摘要:

目的 探讨以失明为首发症状的后组鼻窦囊肿的临床特征，以期早诊断、早治疗，避免引起严重的视力损伤。方法 对近期发生的3例首发症状为失明的后组鼻窦囊肿患者，采集病史，收集实验室及影像学检查，明确诊断后急诊行鼻内镜下鼻窦开放，清除囊肿，并行视神经减压术。术后定期随访，评估视力恢复情况。结果 3例患者术后症状均改善，1例视力恢复至光感，2例视力无改善。结论 对于出现眶周胀痛，且原因不明的急性视力下降患者，应警惕鼻窦囊肿合并感染的可能，积极进行影像学检查有助于早期诊断，及时进行手术，并减压视神经等治疗，有机会改善患者视力预后。

Abstract:

Objective To investigate the clinical features of blindness-leading posterior sinus cyst so as to make early diagnosis and proper treatment to avoid serious visual impairment. Methods Three patients suffering from posterior sinus cysts with blindness as the first symptom were reported. Their clinical data including history, laboratory and imaging results were collected. Once the diagnosis was clear, all patients received urgent endoscopic sinus opening, cysts resection and optic nerve decompression. They were followed up postoperatively to assess visual recovery. Results The symptoms got relieved postoperatively in all 3 patients. Of them, vision recovered to light perception in one and did not improve in the other two. Conclusion In patient with distending periorbital pain and unexplained acute vision loss, the possibility of sinus cyst complicated with infection should be considered. Active imaging examination is helpful for early diagnosis, and timely surgical treatments including optic nerve decompression may facilitate the improvement of visual outcome.