摘要
目的进一步认识蝶窦恶性肿瘤的临床特点、鼻内镜及影像学表现、误诊疾病及治疗效果,以提高诊断与治疗水平。方法对9例蝶窦肿瘤患者的临床资料进行回顾性分析。临床表现为头痛8例,视力下降3例,涕中带血、鼻塞3例,脑神经麻痹2例。误诊为蝶窦炎3例,鼻咽癌2例,脑梗塞、脑积水各1例。手术加术后放射治疗7例,单纯放射治疗1例。结果1例内翻性乳头状瘤恶变随访6年无复发;1例神经内分泌癌随访3年生存;4例治疗后2～3年内死亡,其中1例恶性黑色素瘤治疗后3年死于心肌梗塞,1例腺样囊性癌治疗后3年死亡,2例鳞状细胞癌治疗后2年内死亡:1例低分化鳞状细胞癌和1例恶性黑色素瘤随访1年生存;1例低分化腺癌失访。结论蝶窦恶性肿瘤早期无特殊症状,临床容易误诊和漏诊。对不明原因头痛、视力下降、涕中带血的患者应及早行鼻内镜和鼻窦CT、MRI检查,鼻内镜检查发现蝶筛隐窝小息肉,应及时活检以明确诊断。
OBJECTIVE To investigate the clinical characteristics, nasal endoscope and imaging findings, misdiagnosis and treatment results of sphenoid sinus malignant tumor. METHODS The clinical data of 9 cases with sphenoid sinus malignant tumor were summarized and analyzed. Headache was found in 8 patients, ophthalmic symptoms in 3 patients, nasal bleeding and obstruction in 3 patients, and cranial nerve palsy in 2 patients. They were often misdiagnosed as sphenoid sinusitis and nasopharyngeal carcinoma. RESULTS Only 1 patient with papillary carcinoma was cured for 6 years. One patient with neuroendocrine carcinoma was alive for 3 years after treatment. Four patients died at 2 to 3 years. Two patients were alive at 1 year after operation. One patient was lost to follow up. CONCLUSION Sphenoid sinus tumor had no characteristic symptoms in early stage. It is easy to misdiagnose and delay diagnosis. Patients with headache, visual symptoms and nasal bleeding should take nasal endoscopy, CT scan and MRI examination at early stage.
出处
《中国耳鼻咽喉头颈外科》
北大核心
2008年第9期519-521,共3页
Chinese Archives of Otolaryngology-Head and Neck Surgery
关键词
蝶窦
鼻窦肿瘤
诊断
Sphenoid Sinus
Paranasal SinusNeoplasm
Diagnosis
