摘要
背景：孤立性蝶竇炎雖為臨床上少見之疾病，卻具有潛在致命性。其發病症狀常不明顯且變異性大，故不易早期診斷。本文試將高雄長庚醫院10年來罹患孤立性蝶竇炎的病例，作一概略的整理分析，並參考文獻，探討孤立性蝶竇炎之診斷及治療趨勢。 方法：自1986年1997年間，本科共經歷16例臨床診斷為孤立性蝶竇炎病例。本報告擬就此16例，針對其臨床症狀、全身系統性疾病、治療病程和預後，作一分析比較。 結果：我們發現頭痛可能常是此病早期的唯一症狀，多數患者之症狀可由積極手術治療而改善或痊癒。 結論：蝶竇內視鏡切開術是有效且安全的手術方式。但有免疫缺陷疾病者，容易併發眼窩和顱內合併症，預後較差。因此對於孤立性蝶竇炎的可能性要保持警覺，才能早期診斷、早期治療。
並列摘要
Backgrounds: Isolated sphenoid sinusitis is an uncommon disease. Because of the vague symptoms of this disease, it is usually difficult to be diagnosed early. Any delay in treatment may result in serious and potentially life-threatening complications. Methods: From 1986 to 1997, we came across 16 cases of isolated sphenoid sinusitis. In this report, we retrospectively reviewed and analysed the charts of these patients and summarized the clinical manifestations, concomitant systemic diseases, results of the bacterial cultures, surgical methods, therapeutic courses and results. Results: In this series, headache was found to be the most common symptom and could be the sole initial complaint of the patients. Most of the patients recovered if early diagnosis was made and aggressive surgery performed. Conclusions: At present, endoscopic sphenoidotomy is the mainstay of treatment for isolated sphenoid sinusitis. However, the patients who were immune-compromised had poorer prognosis because of potential orbital and intracranial complications.
延伸閱讀
- 羅盛典（2022）。蝶竇解剖手術。台灣耳鼻喉頭頸外科雜誌，56()，36-41。https://doi.org/10.6286/jtohns.202203/SP_56.0006
- 蔡耀漢、張燕良（1999）。孤立性蝶竇麴菌症－病例報告。慈濟醫學雜誌，11(1)，109-113。https://doi.org/10.6440/TZUCMJ.199903.0109
- 余建興、朱繡棟、余國榮（1993）。原發性蝶竇黏液囊腫－病例報告。中華民國耳鼻喉科醫學會雜誌，28(6)，423-426。https://doi.org/10.6286/1993.28.6.423
- Lin, Y. C., & Tsai, Y. J. (2015). 非侵入孤發性之蝶竇麴菌症造成的單側性外展神經麻痺. 秀傳醫學雜誌, 14(3&4), 115-118. https://doi.org/10.3966/156104972015121403006
- 戴志峰、郭文烈（2007）。Revision Surgery of Recurrent Sinusitis。台灣耳鼻喉頭頸外科雜誌，42()，94-100。https://doi.org/10.6286/2007.42.s_1.94