- 期刊
竇腔鏡雷射去頂術治療Tornwaldt氏囊腫－三例報告
Sinoscopic Laser Deroofing for Tornwaldt's Cyst - Report of Three Cases
摘要
本文報告長庚紀念醫院耳鼻喉科在1995年間所經歷的3例Tornwaldt氏囊腫病例，病患為38及52歲男性與48歲女性，他們的臨床症狀分別為枕部頭痛、鼻涕倒流與鼻咽部異常感。鼻咽鏡檢查時3病患之鼻咽中央都可見一囊腫狀腫塊，電腦斷層掃描顯示其為囊腫狀病變。於是全身麻醉下，以竇腔鏡與影像系統作引導監視，配合二氧化碳雷射光纖管與直式鼻探針，對囊腫周邊以間斷式照射施行去頂術。術後無合併症，2病患之臨床症狀完全消失，另1病患亦有顯著改善。臨床上對於鼻咽部之良性病變，以竇腔鏡配合雷射使用，提供了另一種新的嘗試。
並列摘要
Three patients with Tornwaldt cyst, who underwent CO2 laser deroofing via sinuscope at Chang Gung Memorial Hospital in 1995, were presented in this paper. They were two male and one female. The presenting symptoms were occipital headache, posterior nasopharyngeal drainage and lump sensation of throat. Examination of nasopharynx revealed that a midline smooth mucosa-covered mass was situated in the posterior wall of the nasopharynx in each patient. CT scan showed a low-density, well-circumscribed mass in the nasopharynx. Therefore Tornwaldt’s cyst was diagnosed and patients were scheduled for operation. Surgery was performed under general anesthesia, sinuscope was initially inserted into nose to demonstrate cyst and nasopharynx. A FlexiLase flexible fiber coupled with stratight nasal probe and CO2 laser was installed toward cyst and deroofing of the cyst was done via CO2 laser with repeated mode. Postoperatively, no complication was noted. Occipital headache and posterior nasopharyngeal drainage disappeared. The lump sensation of throat decreased significantly in the third case. No recurrence was found in the follow-up period of 6 to 12 months.