垂体瘤术后并发鼻窦炎的预防及处理

陈晓娟; 张维天

doi:10.13201/j.issn.1001-1781.2016.16.005

垂体瘤术后并发鼻窦炎的预防及处理

陈晓娟,
张维天^,

- 上海交通大学附属上海市第六人民医院耳鼻咽喉头颈外科(上海, 200233)

详细信息

通讯作者: 张维天,E-mail:drzhangwt@163.com

中图分类号: R765.9

收稿日期: 2016-03-21

Prevention and treatment of sinusitis complicated by surgical treatment of pituitary adenoma

CHEN Xiaojuan,
ZHANG Weitian^,

- Department of Otorhinolaryngology Head and Neck Surgery, Affiliated Sixth People's Hospital of Shanghai Jiaotong University, 200233, China

More Information

Corresponding author: ZHANG Weitian, E-mail: drzhangwt@163.com

Received Date: 21 March 2016

摘要

摘要: 目的:探讨经颅入路或者鼻-蝶入路垂体腺瘤切除术后并发鼻窦炎的原因及应对措施。方法:10例垂体瘤术后并发鼻窦炎患者中,5例蝶窦炎和2例额窦炎患者单独采用鼻内镜下手术治疗,3例额窦炎患者采用鼻内镜联合传统的鼻外额窦手术治疗。结果:随访5~20个月,9例治愈,1例好转。均无脑脊液鼻漏等并发症。结论:经颅入路或者鼻-蝶入路垂体瘤术后并发鼻窦炎与术中额窦、蝶窦处理不当以及骨蜡筋膜等异物存留有关,应清除窦内异物、炎性肉芽组织等,保证窦口引流通畅。根据患者具体情况采用单纯鼻内镜或鼻额联合进路进行治疗,均能获得良好的预后。
- 垂体瘤 /
- 鼻窦炎 /
- 内镜外科手术
Abstract: Objective:The aim of this study is to study the reason, prevention and cure measures of sinusitis complicated by frontal craniotomy or endoscopic transnasal approach in surgical treatment of pituitary adenoma.Method:A total of 10 patients with sinusitis complicated by surgical treatment of pituitary adenoma were admitted. Five sphenoid sinusitis patients and 2 frontal sinusitis patients weretreated with nasal endoscopic surgery, while 3 cases frontal sinusitis patients were received nasal endoscopic surgery combined with surgery outside nose.Result:The following up for 5 to 20 months showed that 9 cases were cured and 1 case was improved. There were no cerebrospinal fluid leak and other complications.Conclusion:The sinusitis after frontal craniotomy or endoscopic transnasal approach in surgical treatment of pituitary adenoma may be related to the mishandling of frontal sinus or sphenoid sinusitis and theexistence of the foreign matter such as bone wax and fascia. We should clear the foreign matter and inflammatory granulation tissue to ensure that sinus drainage. According to the specific situation of the patients, good prognosis can be obtained by nasal endoscopic surgery merely or combined with surgery outside nose.
- pituitary adenoma /
- sinusitis /
- endoscopic surgical procedures

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