Sinogenic Complications Involving Orbit, Frontal Sinus, Anterior and MiddleCranial Fossa Treated Using Endoscopic Techniques

K. Oles, J. Skladzien, J. Leszczyńska, K. Bartus, J. Mika
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Abstract

The purpose of this study was to determine the treatment modalities with sinogenic complications. We present a retrospective assessment of 11 patients who developed various types of complications, including an abscess within the temporal bone pyramid, frontal sinus and orbital mucocele, and a subperiosteal abscess with orbital apex syndrome. Three patients have suffered from decreased visual acuity of one eye during the course of chronic sinusitis. Six of the eleven patients had a history of earlier surgeries from external access sites. All patients were treated with Expanded Endonosal Approach at the Otolaryngology Clinic of the Jagiellonian University Medical College. Postoperative follow-up periods were 1 to 5 years. All patients were treated with empirical antibiotic therapy, glucocorticoids and antithrombotics during the peri- and postoperative periods. Postoperative improvement was observed in all patients. No orbital or neurological complications were observed due to the surgical procedure. Summing up, untreated chronic paranasal sinusitis may lead to severe orbital and intracranial complications. Transnasal endoscopy is the gold standard for the treatment of sinogenic complications.
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眼眶、额窦、前颅窝和中颅窝窦源性并发症的内镜治疗
本研究的目的是确定窦性并发症的治疗方式。我们对11例出现各种并发症的患者进行回顾性评估,包括颞骨锥体、额窦和眼眶粘液囊肿内的脓肿,以及伴有眼眶尖综合征的骨膜下脓肿。3例患者在慢性鼻窦炎病程中出现单眼视力下降。11例患者中有6例有早期外部通路手术史。所有患者均在雅盖隆大学医学院耳鼻喉科诊所接受扩大鼻黏膜入路治疗。术后随访1 ~ 5年。所有患者在围手术期和术后均给予经验性抗生素治疗、糖皮质激素和抗血栓药物治疗。所有患者术后均有改善。手术过程中未见眶部或神经系统并发症。综上所述,未经治疗的慢性鼻窦炎可能导致严重的眼眶和颅内并发症。经鼻内窥镜是治疗鼻窦性并发症的金标准。
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