Diagnosis and treatment of spontaneous meningoencephalocele in lateral recess of sphenoid sinus and analysis of its influencing factors
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摘要: 目的 探讨好发于蝶窦外侧隐窝的成人自发性脑膜脑膨出的影响因素，以提高该病的临床诊疗水平。方法 回顾性分析2017年1月-2022年12月郑州大学第一附属医院鼻科27例蝶窦外侧隐窝的成人自发性脑膜脑膨出的临床资料。术前行鼻窦CT及MRI明确诊断及定位脑膜脑膨出位置。结果 ① 蝶窦外侧隐窝Ⅰ型0例，蝶窦外侧隐窝Ⅱ型8例，蝶窦外侧隐窝Ⅲ型19例。②27例好发于蝶窦外侧隐窝的成人自发性脑膜脑膨出患者中男9例，女18例，发病年龄19~72岁，平均(50.7±12.4)岁；18例合并有脑脊液漏，11例伴有头痛、头晕，3例反复发作脑膜炎(合并脑脊液漏)，2例伴有癫痫发作。③20例伴有颅内高压，体重指数(BMI)≥25 kg/m2的患者有17例，合并空蝶鞍8例。结论 成人自发性脑膜脑膨出中以蝶窦外侧隐窝Ⅲ型最常见，且颅内高压、肥胖为该病的影响因素，对怀疑自发性脑膜脑膨出者不可进行穿刺、活检或手术，必须完善影像学检查以明确肿物来源。Abstract: Objective To explore the influencing factors of adult spontaneous meningoencephalocele, which occurs in the lateral recess of sphenoid sinus, in order to improve the level of clinical diagnosis and treatment.Methods The clinical data of 27 adults with spontaneous meningoencephalocele in lateral recess of sphenoid sinus in Department of the Otorhinolaryngology, the First Affiliated Hospital of Zhengzhou University from January 2017 to December 2022 were retrospectively analyzed. Preoperative sinus CT and MRI were performed to confirm the diagnosis and location of meningoencephalocele.Results ① There were 0 cases of lateral recess of sphenoid sinus type Ⅰ, 8 cases of lateral recess of sphenoid sinus type Ⅱ and 19 cases of lateral recess of sphenoid sinus type Ⅲ. ②Among the 27 adult patients with spontaneous meningoencephalocele, 9 were male and 18 were female, and the onset age was 19-72 years old, with an average age of(50.7±12.4) years old. 18 cases were complicated with cerebrospinal fluid leakage, 11 cases with headache and dizziness, 3 cases with recurrent meningitis(complicated with cerebrospinal fluid leakage), and 2 cases with epilepsy. ③There were 20 patients with intracranial hypertension, 17 patients with body mass index(BMI) ≥25 kg/m2, and 8 patients with empty sella.Conclusion Type Ⅲ of lateral recess of sphenoid sinus is the most common type in adult spontaneous meningoencephalocele, and intracranial hypertension and obesity are the influencing factors of this disease. Puncture, biopsy or operation should not be performed for patients suspected of spontaneous meningoencephalocele, and imaging examination should be performed to identify the source of the tumor.
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Key words:
- spontaneous meningoencephalocele /
- adult /
- nasal endoscopic surgery
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