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鄢某某,男,64岁,5月前左上磨牙疼痛,后鼻腔经常出血,颜色鲜红,量少,每次数滴。1月前左面部出现包块。曾在当地医院治疗,效果不明显。1周前来我院诊治,副鼻窦X线摄片:左上颌窦及左鼻腔密度明显增高,上颌窦外侧壁消失,外上壁骨质密度明显增高,边缘光滑锐利,内侧壁模糊,左筛窦密度增高。诊断:①左上颌窦恶性占位性病变?②左上颌窦囊肿所致骨质吸收? 入院检查:T36.3℃,P68次/分,R 16次/分,BP20/ 9 kPa,体瘦,嗜烟,有慢性支气管炎、肺气肿病史,呈慢性病容,全身浅表淋巴结不肿大。专科检查:左侧鼻腔通气差,左下鼻甲稍充血,前端接触中隔,中甲窥不清,中道粘膜充血、肿胀、稍溃烂。左面部上颌窦区前壁有4cm×4cm之包块,较硬。取病变组织活检。手术中发现,
Yan Moumou, male, 64 years old, left upper molars pain before May, after the nasal cavity often bleeds, the color is bright red, the quantity is little, every few drops. A month ago, the left side appeared mass. Had a local hospital treatment, the effect is not obvious. A week ago came to our hospital for diagnosis and treatment of paranasal sinus radiography: left maxillary sinus and left nasal cavity density was significantly increased, the maxillary sinus wall disappeared, the outer wall of the bone density was significantly increased, the edge smooth and sharp, the inner wall blurred, Sinus density increased. Diagnosis: (1) malignant left maxillary sinus space occupying lesion (2) bone absorption caused by left maxillary sinus cyst; admission examination: T36.3 ℃, P68 beats / min, R 16 beats / min, BP20 / 9 kPa, Smoking, chronic bronchitis, emphysema history, was chronic disease, systemic superficial lymph nodes is not enlarged. Specialist examination: poor ventilation of the left nasal cavity, left lower turbinate slightly hyperemia, frontal contact with septum, peep in the nail, middle mucosal congestion, swelling, slightly ulceration. Left anterior maxillary sinus area 4cm × 4cm front of the mass, harder. Take lesion biopsy. Found during surgery,