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报告1例15岁男孩有高热、复视、右眼肿痛、突眼、球结膜水肿、上睑下垂、Ⅲ、Ⅳ、Ⅵ脑神经麻痹和三叉神经上颌支感觉异常等临床表现,住院经鼻窦及眶部CT,证实为全鼻窦炎伴右海绵窦和右眼上静脉血栓形成。经头孢噻肟、灭滴灵、肝素静脉滴注,并立即行功能性鼻内鼻窦手术开放筛、蝶窦引流,术后很快痊愈出院。 在讨论中,指出海绵窦位于颅底,在蝶窦的外上方,是无瓣膜静脉。左右海绵窦在蝶鞍和垂体前后有腔内窦互相沟通。动眼神经、滑车神经和三叉神经眼支及上颌支沿海绵窦外侧壁经过,颈内动脉、交感神经丛和外展神经在近内侧壁处横过海绵窦的中心部。海绵窦血栓性静脉炎可累及这些解剖结构。海绵窦接受面前部、口腔、扁桃体、咽、鼻腔、鼻窦、眼眶、眼球、中耳、乳突区、大脑皮层和垂体的静脉回流,经上下岩窦注入颈内静脉。在过去,面部内三分之一的感染,是海
Reported a 15-year-old boy with high fever, diplopia, right eye swelling and pain, exophthalmos, conjunctival edema, ptosis, Ⅲ, Ⅳ, Ⅵ cranial nerve palsy and sensory trigeminal maxillary sensory dysfunction and other clinical manifestations, And orbital CT, confirmed as sinusitis with right cavernous sinus and right eye vein thrombosis. The cefotaxime, metronidazole, heparin intravenous infusion, and immediately open the functional intranasal sinus surgery open screen, sphenoid sinus drainage, postoperative cured quickly discharged. In the discussion, pointed out that the cavernous sinus at the skull base, outside the sphenoid sinus, is a valveless vein. About cavernous sinus in the sella and pituitary before and after intracavitary sinus communicate with each other. The oculomotor, trochlear and trigeminal branches of the eye and the lateral wall of the maxillary branchal cavernous sinus traverse the internal carotid artery, sympathetic plexus and abducens across the central portion of the cavernous sinus at the proximal medial wall. Cavernous sinus thrombophlebitis can affect these anatomies. Cavernous sinus receiving front anterior, oral, tonsil, pharynx, nasal cavity, sinus, orbit, eyeball, middle ear, mastoid area, cerebral cortex and pituitary venous return, the upper and lower anterior sinus into the jugular vein. In the past, one third of the infections in the face were sea