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目的:探讨经头皮冠状切口径路与经鼻内镜径路额筛眶占位性病变切除术的优缺点及适应证。方法:额筛眶占位性病变患者34例,18例行经鼻内镜额筛眶占位切除术,其中脓囊肿16例,侵袭性血管脂肪瘤1例,骨瘤1例;16例经头皮冠状切口径路手术,其中脓囊肿11例,皮样囊肿3例,表皮样囊肿1例,侵袭性血管脂肪瘤复发1例;术后随访2~4年。结果:18例行经鼻内镜径路患者术后5例仍有头昏或鼻腔胀痛症状,侵袭性血管脂肪瘤1例2年后复发。16例经头皮冠状切口径路手术患者,3例有头昏症状,12例头顶部皮肤麻木,无一例复发。结论:经头皮冠状切口径路与经鼻内镜径路额筛眶占位性病变切除各有其优缺点及适应证,不能盲目夸大其中一种术式的功能。
Objective: To investigate the advantages and disadvantages of indications of orbital occupancy lesion by trans-scalp coronary incision and endoscopic approach. Methods: Forty-four patients with frontal orbital occupying lesions were enrolled. Eighteen patients underwent endoscopic nasal endoscopic orbital mastectomy, including 16 cases of pus cyst, 1 case of invasive lipoma, 1 case of osteoma, 16 cases of There were 11 cases of pus cyst, 3 cases of dermoid cysts, 1 case of epidermoid cysts and 1 case of recurrent vascular lipoma. The patients were followed up for 2 to 4 years. Results: Eighteen patients with nasal endoscopic pathology still had symptoms of dizziness or nasal cavity pain after operation. One case of invasive angiolipoma recurred after 2 years. Of the 16 patients who underwent scalp coronal approach, 3 had dizziness and 12 had apical skin numbness without any recurrence. Conclusion: Transverse scleral coronaries approach and transnasal endoscopic approach to the orbital space occupying lesion have their own advantages and disadvantages and indications, one of which can not blindly exaggerate the function of surgery.