患女,14岁。主诉:左眼球突出伴视力下降及同侧鼻塞1年。患者1年前偶然发现上述症状,在某地以“筛窦囊肿”手术治疗,取同侧唇龈沟切口经上颌窦至筛窦切除囊肿,有囊液流出,囊肿上皮取出。术后眼球未回位,仍有鼻塞,自渐加重,有鼻出血史。入院查体:心肺正常,肝脾肋下未触及,实验室检查未见异常。左眼球向外上方突出,视力0.8,眼球活动好,无复视。左中鼻道后方有一淡红色肿物,活动欠佳,无明显出血,质韧。鼻窦CT示左筛窦内有一约3.5cm×4.5cm的膨胀性破坏,周围密度明显增高,中央密度较低,下方向鼻腔及上颌窦膨出,前上部向左球后突出,CT印象:筛窦骨化纤维瘤。入院初步诊断:左筛窦骨化纤维瘤。术前准备就绪后,插管全麻下行左鼻侧切开入路切除肿瘤,术中见左筛窦前壁小部分骨质破坏,筛窦内有少量淡黄色液体流出,肿瘤向眼眶压迫,筛 Affected women, 14 years old. Chief Complaint: left eye protrusion with decreased visual acuity and ipsilateral nasal obstruction for 1 year. One year ago, the patient accidentally discovered the above symptoms. In a certain area, “ethmoid sinus cyst” surgery was performed. The cyst was excised from the maxillary sinus to the ethmoid sinus at the same side of the sulcus, and the cyst fluid was removed. The cyst epithelium was removed. Postoperative eye did not return, there are still nasal congestion, since the gradual increase, history of epistaxis. Admission examination: normal heart and lung, liver and spleen ribs did not touch, laboratory tests showed no abnormalities. Outstanding left eyeball outwards, visual acuity 0.8, eye activity is good, no diplopia. Left behind the middle of the nasal passages have a light red mass, poor activity, no significant bleeding, quality toughness. Sinus CT showed a 3.5cm × 4.5cm distension of the left ethmoid sinus, the surrounding density was significantly increased, lower central density, the lower nasal cavity and maxillary sinus bulge, the upper front to the left after the ball prominent, CT impression: Sieve Sinus fibrosus. Initial diagnosis of admission: left ethmoid fibrosioma. After preoperative preparation, intubation general anesthesia under the left nasal incision to remove the tumor, the surgery see a small part of the anterior ethmoid sinus wall destruction, a small amount of light yellow liquid within the ethmoid sinus outflow, the tumor to the orbital oppression, screen