鼻竇炎的眼部合併症

Ocular Complications of Paranasal Sinusitis

王鶯娟(Ying-Chuan Wang) ； 游琇瑾(Shew-Gin Yow) ； 林淑妍(Sue-Ann Lin)

《中華民國眼科醫學會會刊》 28卷2期 (1989/05) Pp. 906-912

https://doi.org/10.30048/ACTASOS.198905.0166

摘要

眼窩與副鼻竇緊鄰，兩者的靜脈血流又可雙向交通，因此副鼻竇的炎症可直接經由竇壁或藉著靜脈炎，引起眼部的合併症。Chandler et al.將眼窩發炎分為五群：眼瞼的發炎性水腫、眼窩峰窩組織炎、骨膜下腔膿瘍、眼窩膿瘍及海綿竇血栓靜脈炎。本文就其分類的必要性，臨床發現及電腦斷層攝影的應用，提出報告。治療眼窩的炎症，初步是給予大劑量廣效性的抗生素，並適時做外科探察、膿瘍引流及降低眼窩內壓。本文並列舉七例鼻竇炎引起的眼部合併症。病例1-5，其外眼檢查皆有眼瞼紅腫、結膜充血水腫、眼球突出及動眼受限制的現象，病例5並有中心視網膜動脈阻塞及腦神經第Ⅲ Ⅳ Ⅴ1 Ⅵ麻痺的症候。經系列的檢查，診斷分屬於眼窩發炎第Ⅱ-Ⅴ群。病例6為額篩竇的膿液囊腫(pyocele)，其膨大的竇腔，引起眼窩內上壁的壓力性壞死，膿囊將眼球推向外下方，使病人產生複視。病例7為蝶篩竇的膿液囊腫，它使sella turcica糜蝕變薄，並對視神經產生壓迫，使病人失明。

並列摘要

Infection of the paranasal sinuses may produce serious ocular consequences, ranging from preseptal cellulitis to orbital cellulitis. subperiosteal abscess, orbital abscess, cavernous sinus thrombosis and blindness. Prompt diagnosis and treatment are necessary to prevent severe visual loss and even death. The authors review the anatomical factor, pathogenesis and the five- group classification of orbital inflammation. Seven cases of ocular complications of the paranasal sinusitis are presented in detail about their clinial presentation, diagnostic procedure, treatment and the visual results. Source, bacteriology, CT scanning and treatment of orbital infection are discussed.

並列關鍵字

orbital cellulites ； subperiosteal abscess ； cavernous Sinus thrombosis ； pyocele of paranasal sinus