經鼻內視鏡眼窩減壓手術治療眼窩假性腫瘤

原發性眼窩發炎疾病(idiopathic orbital inflammatory disease, IOID)，又名眼窩假性腫瘤(orbital pseudo-tumor)，為眼睛少見之良性腫瘤。臨床症狀以突眼、動眼疼痛、眼球運動受限和視力受損爲主。診斷靠病史、電腦斷層攝影及病理組織切片。其治療以系統性類固醇為第一線治療，放射性治療、免疫抑制劑和手術治療為輔。在耳鼻喉範圍對此眼部疾病之處理，經驗不多。我們報告1名67歲男性，由於右眼動眼疼痛，眼凸及視力衰退等症狀，經影像檢查疑似為眼窩假性腫瘤，由於此病人對類固醇治療無效，故使用經鼻內視鏡手術，將薄紙版(lamina papyracea)打開，做切片診斷及減壓治療，術後病患的症狀獲得緩解，門診追蹤至今9個月，狀況穩定並無症狀復發現象。經鼻內視鏡眼窩減壓手術提供了眼窩假性腫瘤另一種治療選擇。

關鍵字

原發性眼窩發炎疾病；眼窩假性腫瘤；經鼻內視鏡手術

並列摘要

Idiopathic orbital inflammatory disease, also known as orbital pseudotumor, is a rare, benign orbital tumor that is infrequently seen by Otolaryngologists. Exophthalmos is the most frequent sign of an orbital pseudotumor, followed by ophthalmalgia, motility restriction and loss of visual acuity. The diagnosis can be made based on history, imaging studies such as computerized tomography, and histopathology. The initial treatment of choice is systemic corticosteroids, but alternative treatment modalities are available, including radiotherapy, immunosuppressive agents, and surgery. We report a case of a sixty-seven years old man who suffered from recurrent ophthalmalgia, proptosis and loss of visual acuity in the right eye despite prednisolone use. Since the imaging studies and the clinical course were suggestive of idiopathic orbital inflammatory disease, the patient underwent endoscopic sinus surgery to remove the lamina papyracea for biopsy and decompression. After decompression, the patients discomfort settled. Over a nine month follow-up period, the patient had no more episodes of intolerable ophthalmalgia. Endoscopic orbital decompression represents another potential treatment for orbital pseudotumor.

並列關鍵字

idiopathic orbital inflammatory disease ； orbital pseudotumor ； endoscopic sinus surgery

國際替代計量

經鼻內視鏡眼窩減壓手術治療眼窩假性腫瘤

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