鼻内镜下鼻窦骨纤维异常增殖症累及颅底或眼眶的手术治疗

Surgical treatment of fibrous dysplasia of paranasal sinuses involving skull base or orbit under nasal endoscope

摘要:

目的 探讨鼻内镜下鼻窦骨纤维异常增殖症累及颅底或眼眶的手术治疗与经验总结。方法 回顾性分析2017年7月—2020年12月南京大学医学院附属鼓楼医院耳鼻咽喉头颈外科收治的13例采用鼻内镜手术治疗累及颅底或眼眶的鼻窦骨纤维异常增殖症患者的临床资料，结合手术治疗及术后疗效进行综合评价。结果 13例患者术后均无严重并发症，受累颅底或眼眶病变组织彻底切除，无眼球功能障碍及脑脊液鼻漏。随访6～48个月，所有患者均无复发。结论 对于累及颅底或眼眶的鼻窦骨纤维异常增殖症的患者，鼻内镜结合导航及等离子技术可彻底切除病变组织以达到功能重建的效果。

关键词:鼻内镜;骨纤维异常增殖症;颅底;眼眶;导航;等离子

Abstract:

Objective To investigate the surgical treatment of fibrous dysplasia of paranasal sinuses involving skull base or orbit under nasal endoscope. Methods Clinical date of 13 patients treated with endoscopic surgery for fibrous dysplasia of paranasal sinuses involving skull base or orbit were analyzed retrospectively, and a comprehensive evaluation was conducted combining with the surgical and postoperative treatments as well as the treatment effect. Results None of the patients exhibited severe complications. The affected skull base or orbital lesions were completely resected in all the cases, and neither ocular dysfunction nor cerebrospinal fluid rhinorrhea was observed. Follow-up period ranged from 6 to 48 months, and all patients had no recurrence. Conclusion For patients with fibrous dysplasia of paranasal sinuses involving skull base or orbit, nasal endoscopic surgery combined with navigation and plasma technology can completely remove the diseased tissue to achieve the effect of functional reconstruction.

Key words:Nasal endoscopy;Fibrous dysplasia;Skull base;Orbit;Navigation;Plasma