山东大学耳鼻喉眼学报 ›› 2015, Vol. 29 ›› Issue (2): 36-40.doi: 10.6040/j.issn.1673-3770.0.2014.409

• 论著 • 上一篇    下一篇

鼻内镜手术治疗鼻-眶-颅底骨纤维异常增殖症4例

李安, 李娜, 姜彦, 于龙刚, 刘慧, 许彤, 孔祥斌   

  1. 青岛大学附属医院耳鼻咽喉头颈外科, 山东 青岛 266003
  • 收稿日期:2014-12-17 出版日期:2015-04-16 发布日期:2015-04-16
  • 作者简介:李安。E-mail:li_an0835@163.com
  • 基金资助:
    国家自然科学基金(81170895)

Nasal endoscopic surgery for fibrous dysplasia involving rhino-orbito-skull base: a report of 4 cases

LI An, LI Na, JIANG Yan, YU Long-gang, LIU Hui, XU Tong, KONG Xiang-bin   

  1. Department of Otorhinolaryngology & Head and Neck Surgery, Affiliated Hospital of Qingdao University, Qingdao 266003, Shandong, China
  • Received:2014-12-17 Online:2015-04-16 Published:2015-04-16
  • Contact: 李娜。E-mail:dr.lina@163.com E-mail:dr.lina@163.com

摘要: 目的 探讨鼻内镜手术治疗鼻-眶-颅底骨纤维异常增殖症的方法及预后。方法 回顾分析4例经鼻内镜手术治疗的累及鼻腔鼻窦、眼眶、颅底的骨纤维异常增殖症的临床资料。其中男1例, 女3例, 5~17岁, 中位年龄13岁。临床表现为鼻塞、头痛、流涕、嗅觉减退, 其中1例伴双眼视力下降。病变累及筛骨4例, 蝶骨2例, 额骨2例, 上颌骨2例, 颧骨、颞骨、枕骨1例。结果 4例均在鼻内镜下经鼻将病变组织大部分切除。随访13~123个月, 鼻塞、头痛、流涕均逐渐消失, 嗅觉好转, 鼻腔黏膜上皮化良好。1例视力下降者术后视力略有好转, 但4年后视力再次下降行二次手术。4例均未出现手术并发症, 效果满意。结论 鼻内镜手术治疗鼻-眶-颅底骨纤维异常增殖症安全、有效, 损伤小, 不仅可以恢复鼻腔鼻窦生理功能、改善临床症状, 而且对预防及治疗并发症也有积极作用。

关键词: 鼻窦, 骨纤维异常增殖症, 鼻内镜外科手术, 眼眶, 颅底

Abstract: Objective To investigate the treatment method and prognosis of fibrous dysplasia involving rhino-orbito-skull base. Methods The clinical data of 4 cases of fibrous dysplasia involving rhino-orbito-skull base treated with nasal endoscopic surgery were retrospectively analyzed. There was 1 male and 3 females aging from 5 to 17 years with a median age 13 years. Their clinical manifestations included headache, rhinorrhea, hyposmia and nasal obstruction, except of visual deterioration in 1 case. The primary sinus involved was the ethmoid (4), sphenoid (2), frontal (2), maxillary (2), and skull (1). Results All the patients were followed up of 13-123 months. The symptoms such as headache, rhinorrhea and nasal obstruction disappeared after the operation, olfactory dysfunction was better, and the nasal cavity epithelization was well. The case of visual deterioration was re-operated 4 years later because of recurrence. All the patients had no complications and had satisfied outcome. Conclusion The nasal endoscopic surgery is safe, effective and results in less injury for fibrous dysplasia involving rhino-orbito-skull base. It not only can repristinate nasal sinuses physiological function and improve clinical symptoms, but also has positive effect on prevention and treatment of complications.

Key words: Fibrous dysplasia, Orbit, Skull base, Endoscopic surgical procedures, operative, Nasal sinus

中图分类号: 

  • R765.9
[1] 赵红叶,张惠箴,蒋志铭.骨的纤维结构不良临床病理学和分子遗传学研究[J].临床与实验病理学杂志, 2008, 24(3):358-360. ZHAO Hongye, ZHANG Huizhen, JIANG Zhiming. Study on the clinical pathology and molecular genetics of fibrous dysplasia of bone[J]. Chin J Clin Exp Pathol, 2008, 24(3):358-360.
[2] Jurlina M, Janjanin S, Melada A, et al. Large intracranial intradural mucocele as a complication of frontal sinus osteoma [J]. J Craniofac Surg, 2010, 21(4):1126-1129.
[3] Papay F A, Morales L Jr, Flaharty P, et al. Optic nerve decompression in cranial base fibrous dysplasia[J]. J Craniofac Surg, 1995, 6(1):5.
[4] 周维国,倪鑫,黄志刚,等.累及颅底的骨纤维异常增生症的治疗[J].临床耳鼻咽喉头颈外科杂志, 2009, 23(13):601-603. ZHOU Weiguo, NI Xin, HUANG Zhigang, et al. The treatment of fibrous dysplasia involving skull base[J]. J Clin Otorhinolaryngol Head Neck Surg, 2009, 23(13):601-603.
[5] Maher C O, Friedman J A, Meyer F B, et al. Surgical treatment of fibrous dysplasia of the skull in children[J]. Pediatr Neurosurg, 2002, 37(1):87-92.
[6] 孙岩,张庆泉,宋西成,等.影像导航辅助鼻内镜下治疗鼻窦骨纤维异常增殖症的应用体会[J].临床耳鼻咽喉头颈外科杂志, 2013, 27(2):57-60. SUN Yan, ZHANG Qingquan, SONG Xicheng, et al. Applicationexperienceofendoscopictreatingsinusbonefibrousdysplasiaundernavigationguidance[J]. J Clin Otorhinolaryngol Head Neck Surg, 2013, 27(2):57-60.
[7] 韩德民,周兵.鼻内镜外科学 [M]. 2版.北京:人民卫生出版社, 2012:316-317.
[8] 葛文彤,周兵,韩德民,等.影像导航系统下的鼻内镜手术[J].中华耳鼻咽喉科杂志, 2004, 39(2):135-138. GE Wentong, ZHOU Bing, HAN Demin, et al.Imaging-navigated endoscopic sinus surgery[J]. Chin J Otorhinolaryngol Head Neck Surg, 2004, 39(2):135-138.
[9] Selmani Z, Aitasalo K, Ashammakhi N. Fibrous dysplasia of the sphenoid sinus and skull base presents in an adult with localized temporal headache [J]. J Craniofac Surg, 2004, 15(2):261-263.
[1] 冯思聪,于晓岚,娄丹. 基于囊泡组织Ki67、GM-CSF表达评估Messerklinger中鼻甲成形术对慢性鼻-鼻窦炎合并鼻息肉的效果[J]. 山东大学耳鼻喉眼学报, 2026, 40(3): 31-39.
[2] 翟雪纯,边欣,陈敬彩,邓家钰,叶子,杨萍丽. 慢性额窦炎患者焦虑抑郁特点及横断面研究[J]. 山东大学耳鼻喉眼学报, 2026, 40(2): 35-43.
[3] 唐嘉骏,后婕,窦鑫,俞晨杰. 鼻腔框架结构畸形影响鼻腔结构及鼻窦气化的CT研究进展[J]. 山东大学耳鼻喉眼学报, 2026, 40(2): 102-110.
[4] 卢朝阳, 翟兆雪, 王慧康, 邵丽婷, 张宇. 新冠肺炎治疗引发糖尿病酮症酸中毒合并鼻眶脑型毛霉菌病1例并文献复习[J]. 山东大学耳鼻喉眼学报, 2026, 40(1): 90-94.
[5] 朝博,苏优勒,郭若宇,付嘉越,吕宪利. 侧颅底硬脑膜动静脉瘘的特点及治疗[J]. 山东大学耳鼻喉眼学报, 2025, 39(6): 1-7.
[6] 李赞,卢奇,申卫东,侯昭晖,吴南. 坏死性外耳道炎临床诊治18例[J]. 山东大学耳鼻喉眼学报, 2025, 39(6): 17-22.
[7] 李阳松,袁发洋,杨艳,张田,喻国冻. 基于Web of Science进行生物制剂治疗慢性鼻窦炎文献计量学分析[J]. 山东大学耳鼻喉眼学报, 2025, 39(6): 54-64.
[8] 杜康丽,郑振宇,徐战将,张宇,陈露,卢梦垚. 鼻中隔偏曲并发慢性鼻窦炎风险预测模型的构建与验证[J]. 山东大学耳鼻喉眼学报, 2025, 39(6): 78-86.
[9] 熊琴, 张砚, 乌日娜, 李锋, 唐力行. 鼻用糖皮质激素在儿童中的应用[J]. 山东大学耳鼻喉眼学报, 2025, 39(6): 160-167.
[10] 黄焕,华红利,邓玉琴,江承洋,王雨薇,杨星海. 儿童过敏性鼻炎、扁桃体腺样体肥大和鼻窦炎之间相关性及其对临床指导价值[J]. 山东大学耳鼻喉眼学报, 2025, 39(5): 34-41.
[11] 张家齐,袁野,洪陈,顾敏,程雷,陆美萍. 基于孟德尔随机化的肠道菌群与慢性鼻窦炎鼻息肉的因果关系及代谢物中介研究[J]. 山东大学耳鼻喉眼学报, 2025, 39(5): 49-60.
[12] 王再兴,唐志元,李定波,石照辉,曾宪海,张秋航. 鼻咽癌放疗后肿瘤复发及颅底骨坏死引起颈内动脉破裂的治疗方案[J]. 山东大学耳鼻喉眼学报, 2025, 39(4): 49-58.
[13] 孙芳,谢楚波,邱前辉. 营养指标对鼻咽癌放射性颅底坏死患者创面修复影响的回顾性分析[J]. 山东大学耳鼻喉眼学报, 2025, 39(4): 59-68.
[14] 姜知临,朱瑞楷,邱前辉. 基于影像学对咽旁颈内动脉走行的观察与分析[J]. 山东大学耳鼻喉眼学报, 2025, 39(4): 69-76.
[15] 吴家荣,邱前辉. 颅底筋膜组织在早期复发性鼻咽癌内镜手术中的临床意义[J]. 山东大学耳鼻喉眼学报, 2025, 39(4): 108-113.
Viewed
Full text


Abstract

Cited

  Shared   
  Discussed   
No Suggested Reading articles found!