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目的:探讨鼻源性突眼的诊断和治疗,以降低其误诊、漏诊的发生率。方法:对本院1998年1月~2005年10月62例鼻源性突眼患者进行回顾性分析。结果:62例鼻源性突眼患者中,47例首诊眼科,15例以鼻塞、头痛、鼻出血等症状首诊于耳鼻咽喉科。其中额筛囊肿18例,全组鼻窦炎12例,真菌性额窦炎6例,上颌窦癌10例,嗅神经母细胞瘤4例,外伤性颈动脉海绵窦瘘6例,筛窦骨瘤6例。全部病例均经CT、MRI或病理检查确诊。额筛囊肿、筛窦骨瘤及鼻窦炎引起的突眼患者全部治愈。上颌窦癌引起的突眼患者术后随访5年,2例健在,2例失访;嗅神经母细胞瘤引起的突眼患者术后2年均死亡;外伤性颈动脉海绵窦瘘引起的突眼患者2例死亡,4例治愈。结论:以突眼为主要表现的鼻科疾病临床上少见,临床医师对该病认识不足易致误诊、漏诊,根据造成突眼的病因,选择正确的治疗方案,可获满意治疗效果。
Objective: To investigate the diagnosis and treatment of nasal exophthalmos to reduce the incidence of misdiagnosis and missed diagnosis. Methods: A retrospective analysis was performed on 62 cases of nasal exophthalmos from January 1998 to October 2005 in our hospital. Results: Of the 62 cases of nasal exophthalmos, 47 cases were diagnosed with ophthalmology first and 15 cases were diagnosed with nasal obstruction, headache and nosebleed in the otolaryngology department. Among them, 18 cases were screened for frontal stroma, 12 cases were sinusitis in the whole group, 6 cases were fungal frontal sinusitis, 10 cases were maxillary sinus cancer, 4 cases were olfactory neuroblastoma, 6 cases were traumatic carotid cavernous fistula, 6 cases. All cases were confirmed by CT, MRI or pathological examination. The amount of sieve cyst, ethmoid sinusoma and sinusitis caused by exophthalmos patients were cured. Patients with exophthalmos caused by maxillary sinus cancer were followed up for 5 years, 2 cases were alive, and 2 cases were lost to follow-up. Patients with ocular neuroblastoma who had exophthalmias died 2 years after surgery; traumatic carotid-cavernous fistula-induced processes Two patients died in the eye and four were cured. CONCLUSIONS: Rhinologic diseases with prominent eyes as the main manifestation are rare clinically. Clinicians are misleading and misdiagnosed due to lack of understanding of the disease. Choosing the correct treatment plan according to the etiology of exophthalmos may achieve satisfactory therapeutic effect.