單側鼻腔鼻竇疾病

背景：單側鼻腔及鼻竇疾病在耳鼻喉科門診並不罕見。相較於雙側病變，其惡性率較高。因此，術前正確的評估對於往後治療的方式及預後相當重要。本研究希望藉由分析近年來的單側鼻腔及鼻竇疾病之病例，提供更多診斷及治療的資料。方法：此回溯性研究乃收集自1997年1月至1998年8月，在本院耳鼻喉部最終診斷為單側鼻腔及鼻竇疾病之住院病患，根據其臨床表現、電腦斷層掃描和上頜竇超音波檢查結果、手術發現及病理診斷，分析其病灶範圍、疾病類型以及接受治療的方式。結果：因鼻腔及鼻竇疾病住院的患者共484名，其中單側者139名，佔28.7%。病變範圍以上頜竇最常見，疾病類型以慢性鼻竇炎最多，佔48.9%，其他尚包括黴菌性鼻竇炎、黏液囊腫、良性腫瘤、惡性腫瘤等。而電腦斷層掃描和上頜竇超音波檢查對於慢性鼻竇炎的診斷率分別為91.2%及81.3%，且電腦斷層掃描對於惡性腫瘤有80%的診斷率。治療方式則依臨床診斷之不同而有所差異，若為良性病灶，其治療方式大多數採用功能性內視鏡鼻竇手術，惡性腫瘤則多以根除性手術加上術後放射線治療為主。結論：單側鼻腔及鼻竇疾病之病因雖然以慢性鼻竇炎為多，但對於惡性腫瘤仍不可掉以輕心。由於電腦斷層掃描的高診斷率，現已成為鼻腔及鼻竇病變的常規檢查項目，除了藉以了解病灶的範圍外，尚可作為術前鑑別診斷之參考。而上頜竇超音波檢查對於門診的慢性鼻竇炎患者提供了快速、簡便、無放射劑量的優點，可作為臨床醫師用藥的參考。

關鍵字

慢性副鼻竇炎；黴菌性鼻竇炎；功能性內視鼻竇手術；單側鼻腔及鼻竇疾病

並列摘要

Background: Unilateral sinonasal diseases are not uncommon in our out-patient clinic. In this report, we analyze patients with unilateral sinonasal disease to obtain information on diagnosis and treatment. Methods: All patients with unilateral sinonasal diseases treated at Veterans General Hospital-Taipei between January, 1997 and August, 1998 were reviewed retrospectively. The clinical features, etiology, imaging studies, diagnostic methods and the strategy for diagnosis and treatment were discussed. Results: One hundred and thirty-nine patients, including 88 men and 51 women, were included. The most common site of lesion was the maxillary sinus and 48.9% of patients were diagnosed with chronic paranasal sinusi-tis. CT scanning and ultrasonography were useful in the diagnosis of chronic paranasal sinusitis. The methods of treatment differed depending on the pathological diagnosis and the extent of disease. Conclusions: The possibility of malignancy should always be kept in mind although the most common etiology of unilateral pathological lesions in sinonasal cavities was chronic paranasal sinusitis as in previous reports. CT scanning is the most common tool used for differential diagnosis and preop-erative evaluation of the extent of the lesion.

並列關鍵字

chronic paranasal sinusitis ； fungal sinusitis ； functional endoscopic sinus surgery ； unilateral sinonasal disease

國際替代計量

單側鼻腔鼻竇疾病

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