内镜鼻窦手术（ESS）治疗窦眶骨瘤的结局：一项为期12年的多中心经验及文献复习的眼部表现与视力结局

文献信息

中文摘要

背景： 骨瘤是最常见的良性颅面骨肿瘤，可延伸至眼眶腔。虽然大多数骨瘤保持无症状，但眼眶受累可导致具有临床意义的眼科表现。尽管内镜鼻窦手术（ESS）的应用日益增多，但专门针对窦眶骨瘤ESS术后眼科结局的数据仍然有限。
方法： 这项为期12年的多中心描述性队列研究评估了12例接受ESS治疗的症状性窦眶骨瘤患者，在适当时采用了Draf技术及眶移位等先进入路。收集并回顾了人口学资料、临床与影像学表现、肿瘤特征、手术结局及随访期间的并发症。
结果： 该队列人群（7例男性，5例女性；平均年龄29.75岁）主要表现为眼球突出，其次为复视、视物模糊和眼睑肿胀。肿瘤最常起源于额筛窦和额窦，平均肿瘤尺寸为4.2*2.9*1.9 cm。所有病例最终均通过单次或计划性分期ESS实现了完全切除。超过90%的患者视力症状得到缓解或显著改善。未观察到复发、脑脊液漏、重大术后眼眶并发症或美容畸形。
结论： 我们的研究结果支持内镜技术在窦眶骨瘤中作为有效且安全的微创方法的作用不断扩大，并能以极低的并发症发生率实现较高的视力症状缓解率。建议将全面的眼科评估作为多学科方法的一部分，以改善疑似病例的结局。

英文摘要

BACKGROUND: Osteomas are the most common benign craniofacial bone tumors that may extend into the orbital cavity. While the majority of them remain asymptomatic, orbital involvement can lead to clinically significant ophthalmologic manifestations. Although endoscopic sinus surgery (ESS) has been increasingly utilized, data focusing specifically on ophthalmologic outcomes following ESS in sino-orbital osteomas are limited.
METHODS: This 12-year multicenter descriptive cohort evaluated 12 patients with symptomatic sino-orbital osteomas managed with ESS, including advanced approaches such as Draf techniques and orbital transposition when indicated. Demographics, clinical and radiological presentation, tumor characteristics, surgical outcomes and complications during follow-up were collected and reviewed.
RESULTS: The cohort population (7 men, 5 women; mean age 29.75 years) predominantly presented with proptosis, followed by diplopia, blurred vision and eyelid swelling. They originated most frequently from the frontoethmoidal and frontal sinuses with mean tumor dimensions of 4.2*2.9*1.9 cm. Complete excision was ultimately achieved in all cases either through a single or planned staged ESS. More than 90% of patients experienced resolution or substantial improvement of visual symptoms. No recurrences, cerebrospinal fluid leaks, major postoperative orbital complications or cosmetic deformities were observed.
CONCLUSION: Our findings favor the expanding role of endoscopic techniques as an effective and safe minimally invasive approach and offer substantial rates of visual symptom resolution with minimal morbidity in sino-orbital osteomas. Comprehensive ophthalmic evaluation is recommended as part of a multidisciplinary approach to enhance the outcome of suspected cases.