患者,女,48岁。右侧头痛1年,伴右眼进行性视力下降10d。无鼻塞、流涕,无眼科病史。初于眼科就诊,行CT检查发现右蝶窦密度增高影,遂以“右蝶窦炎”收入我科。体检:T37℃,鼻腔未见明显异常,右眼光感,眼底无异常。CT发现右侧蝶窦低密度软组织病灶,可疑累及右视神经孔、眶上裂区,其它鼻窦透亮度好。常规检查无异常,即行鼻内镜下右蝶窦开放引流,术中打开蝶窦前壁见窦腔黏膜肥厚、腔小、腔内有纤维样组织, Patient, female, 48 years old. Right headache for 1 year, accompanied by right eye decreased visual acuity 10d. No stuffy nose, runny nose, no history of ophthalmology. Early in the ophthalmology clinic, line CT examination found that the right sphenoid sinus density increased shadow, then to “right sphenoid sinusitis ” income in our department. Physical examination: T37 ℃, no obvious nasal abnormalities, light perception of the right eye, fundus without exception. CT found soft right lower sphenoid soft tissue lesions, suspicious involvement of the right optic nerve hole, supraorbital fissure, other sinus permeability good brightness. Routine examination without exception, that is, under endoscopic nasobiliary sinus open drainage, sinus surgery open the sphenoid mucosa in the anterior wall hypertrophy, small cavity, intracavitary fibrous tissue,