雙側額篩竇黏液囊腫合併兩眼眶侵犯

Bilateral Fronto-ethmoid Sinus Mucoceles with Bilateral Orbital Involvement

簡德源(Der-Yuan Chian) ； 陳建志(Jiann-Jy Chen) ； 林吉和(Ji-Ho Lin) ； 魏銘華(Ming-Hua Wei) ； 胡克信(Ko-Hsin Hu)

《台灣耳鼻喉頭頸外科雜誌》 42卷6期 (2007/12) Pp. 211-214

https://doi.org/10.6286/2007.42.6.211

摘要

鼻竇黏液囊腫是鼻竇黏液被僞複層柱狀上皮(pseudostratified columnar epithelium)所侷限，在鼻竇內逐漸成長與擴張，甚至侵犯到鄰近的結構，好發於額竇及篩竇，且多爲單側病灶，雙側較爲少見(4%)。本院於2006年初遇一65歲女性，主訴左眼視力模糊及複視約1年多，理學檢查發現左眼球突出，眼球運動受到影響，無法向右注視。住院期間安排電腦斷層及磁振造影顯示疑似雙側額竇及篩竇之軟組織腫瘤，且侵犯左側眼眶，壓迫左側眼內直肌，遂安排鼻竇內視鏡手術設法採樣及切除。術中發現僅爲雙側額竇及篩竇之黏液囊腫，於是進行雙側黏液囊腫造袋術(marsupialization)，引流出其中的膿液。術後追蹤3個月，電腦斷層檢查顯示無復發之跡象，左側眼球活動較術前進步，已無視力模糊及複視等現象。鑒於雙側額－篩竇黏液囊腫並不多見，故提出此病例報告。

關鍵字

黏液囊種 ； 造袋術

並列摘要

A mucocele is a ball of concentrated mucus surrounded by a layer of pseudo-stratified columnar epithelium. It gradually grows and slowly expands in a paranasal sinus cavity, and even erodes the adjacent structures. Most paranasal sinus mucoceles occur in the frontal and ethmoid sinues. Mucoceles are usually unilateral, and are rarely bilateral (4%). A 65-year-old woman presented with decreased vision in the left eye and diplopia for one year. Physical examination revealed right gaze limitation because of leftside exophthalmos. Computed tomography and magnetic resonance imaging revealed two soft-tissue masses arising from the bilateral paranasal sinuses, and invading the bilateral orbits; furthermore, the left medial rectus muscle was more displaced than the right. Endoscopic sinus surgery was performed first. After mucus drainage, mucoceles were diagnosed and then marsupialized. The postoperative course was uneventful. The movement of the left eye was much improved, and there was no decreased vision or diplopia. Three months later, computed tomography showed no evidence of recurrence.

並列關鍵字

mucocele ； marsupialization