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目的探讨鼻窦眼眶区良性占位性病变手术径路的选择。方法根据良性占位性病变侵犯的部位,将116例鼻窦眼眶区良性占位性病变患者分为额筛眶区、蝶筛眶区和颌筛眶区;其中额筛眶区16例,包括鼻内镜径路6例,联合径路(鼻内镜手术+鼻外开放式手术)8例,鼻外径路2例;蝶筛眶区40例,为鼻内镜径路;颌筛眶区60例,包括鼻内镜径路42例,联合径路12例,鼻外径路6例。结果蝶筛眶区40例良性占位性病变均经鼻内镜径路切除病灶,且手术视野好,病变清除彻底,未见复发,所有患者术后无眶内及颅内并发症;鼻内镜径路对48例颌筛眶区脓囊肿、上颌窦内侧壁良性占位性病变及某些额筛眶区脓囊肿也能较容易的清除病灶,但对28例额筛眶区、颌筛眶区某些特殊的良性占位性病变却很难完成。结论鼻内镜径路是治疗蝶筛眶区良性占位性病变、颌筛眶区脓囊肿、上颌窦内侧壁良性占位性病变及额筛眶区某些脓囊肿的理想选择。
Objective To explore the choice of surgical approach for benign lesions in the orbital area of the sinuses. Methods One hundred and sixteen patients with benign lesions in the orbital sinus were divided into frontal orbital, butterflies and orbital areas according to the sites of benign lesions. Among them, 16 were orbital areas, including nasal Endoscopic approach in 6 cases, combined approach (endoscopic sinus surgery + open surgery outside the nose) in 8 cases, 2 cases of nasal diameter; butterfly orbital 40 cases of endoscopic path; jaw orbital in 60 cases, including 42 cases of nasal endoscopic approach, 12 cases of combined approach, 6 cases of nasal approach. Results Forty cases of benign space-occupying lesions in the orbital area were removed by endoscopic sinus surgery. The operative field of vision was good, the lesions were completely eliminated and no recurrence was found. No intraorbital or intracranial complications occurred in all patients. Nasal endoscopy Pathway 48 cases of maxillary orbital abscess cyst, maxillary sinus medial wall benign lesions and some of the amount of orbital pleurisy can also be easier to clear the lesion, but 28 cases of the frontal orbital, jaw orbital area Some special benign space-occupying lesions are difficult to accomplish. Conclusions Nasal endoscopic approach is an ideal choice for the treatment of benign lesions in the orbital zone, benign orbital abscess, maxillary medial space occupying benign lesions and nasal mucosa in frontal orbit.