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患者男,15岁.因右侧鼻根部隆起,内眦及右眼球向外移位半年余,于1992年11月27日入院.检查全身无明显异常发现.实验室检查未见异常.专科检查:外鼻右侧根部隆起,可触及肿物约2cm×3cm×2cm大小,质硬,不活动,表面肤色正常,右眼球及内眦向外侧移位.鼻腔粘膜无充血,各鼻岬无肥大,鼻中隔无偏曲,诸鼻道未见脓性分泌物,副鼻窦区无明显压痛.鼻窦X线摄片报告:右筛窦前组膨胀环影,考虑良性病变,粘液囊肿及气囊肿之可能.CT检查报告:右侧筛窦囊肿.治疗经过:入院时印象(1)筛窦囊肿;(2)怀疑筛窦肿瘤.于12月7日在全麻下做筛窦探查术,行右侧鼻根部切口,术中见筛窦前骨壁已瘤体破坏,扩大窦腔见内有豆渣样物质,恶臭,整个瘤体压迫腐蚀内侧壁骨质使之破坏,下壁与鼻腔相通.刮除窦腔内豆渣样物质连同瘤体包膜一同清除.约3.0cm×2.0cm×2.5cm大小,自窦腔置一引流管于鼻腔.术后1周取出引流管.摘除物送病理检查,病理诊断为筛窦胆脂瘤,于12月16日痊愈出院.
Male patient, aged 15. Due to the right side of the nasal root uplift, the internal lobe and the right eye outward shift more than six months, admitted to hospital on November 27, 1992. No abnormalities were found in the whole body examination. No abnormal laboratory tests. : The outer root of the right side of the nose uplift, palpable tumor size of about 2cm × 3cm × 2cm, hard, inactive, normal skin color, the right eye and the medial malleoli shift to the lateral nasal mucosa without congestion, the promontory no hypertrophy , Nasal septum no deviation, no nasal purulent secretions, no significant paranasal sinus tenderness. Sinus X-ray report: right anterior ethmoid anterior group expansion ring shadow, consider the possibility of benign lesions, mucus cysts and cysts may .CT examination report: right ethmoid sinus cyst. After treatment: impression of admission (1) ethmoid sinus cyst; (2) suspected ethmoid sinus cancer .Depending on December 7 under general anesthesia ethmoidectomy, the right Nasal root incision, intraoperative see the ethmoid anterior wall of the tumor has been destroyed, to expand the sinus see the bean residue-like material, stench, the entire tumor pressure corrosion of the medial wall of the bone to make the destruction of the lower wall and nasal communication. Sinusoid residue-like material along with the tumor capsule removed together about 3.0cm × 2.0cm × 2.5cm size, a drainage tube from the sinus cavity in the nasal cavity after 1 week A drainage tube was removed for pathologic diagnosis of pathological sinus cholesteatoma, on December 16 were discharged.