Abstract：
Objective:To compare the efficacy of endoscopic sinus surgery and conservative treatment for orbital apex syndrome caused by sinus lesions. Methods:The clinical data of 56 patients with orbital apex syndrome caused by sinus lesions who were admitted to the First Affiliated Hospital of Zhengzhou University from January 2018 to August 2023 were retrospectively analyzed and divided into a surgical group of 21 cases and a conservative group of 35 cases. The clinical features and prognosis of the two groups were compared. Results:Among the sinus lesions in the surgical group, 61.9% were fungal sinusitis, 28.6% were bacterial sinusitis, and 9.5% were sphenoid sinus tumors. In the conservative group, non-fungal sinusitis accounted for 65.7% and fungal sinusitis accounted for 34.3%. In addition to sinus lesions, patients had underlying diseases. In the surgical group, 71.4% had hypertension and 80.9% had diabetes; in the conservative group, 28.6% had hypertension and 42.9% had diabetes. After a follow-up of 1 month to 5 years, the symptom improvement rate in the surgical group was 85.7%, with 1 case of recurrence. No recurrence was found after reoperation, while the symptom improvement rate in the conservative group was 22.9%, and 6 cases recurred after symptom improvement, and were transferred to rhinology department. No recurrence was seen after surgery. Conclusion:Most of the sinus lesions in this study were fungal sinusitis. In addition, patients with underlying diseases such as diabetes, hypertension, nephrotic syndrome, etc. have reduced nasal immunity, which significantly increases the risk of disease. Since early nasal symptoms are not obvious, multidisciplinary cooperation in diagnosis and treatment is very necessary. Once imaging examination suggests orbital apex syndrome caused by sinus lesions, endoscopic sinus opening should be performed as soon as possible.
目的：比较鼻窦病变引起的眶尖综合征鼻内镜手术治疗和保守治疗的疗效。 方法：回顾性分析2018年1月-2023年8月郑州大学第一附属医院收治的56例因鼻窦病变引起眶尖综合征患者的临床资料，分为手术组21例，保守组35例，比较两组的临床特征及预后。 结果：鼻窦病变中手术组真菌性鼻窦炎占61.9%，细菌性鼻窦炎占28.6%，蝶窦肿瘤占9.5%。保守组非真菌性鼻窦炎占65.7%，真菌性鼻窦炎占34.3%。除鼻窦病变外，患者合并有基础疾病，手术组中高血压占71.4%，糖尿病占80.9%；保守组中高血压占28.6%，糖尿病占42.9%。随访1个月~5年，手术组症状改善率为85.7%，复发1例，再次手术后未见复发；而保守组症状改善率为22.9%，症状改善后再复发6例，转至鼻科手术后未见复发。 结论：本研究中鼻窦病变多为真菌性鼻窦炎，此外，合并糖尿病、高血压、肾病综合征等基础疾病的患者鼻部免疫力下降，显著增加了发病风险。由于早期鼻部症状不明显，多学科合作诊疗十分必要。影像学检查一旦提示为鼻窦病变引起的眶尖综合征，需尽早进行鼻内镜下鼻窦开放术。.
目的：比较鼻窦病变引起的眶尖综合征鼻内镜手术治疗和保守治疗的疗效。 方法：回顾性分析2018年1月-2023年8月郑州大学第一附属医院收治的56例因鼻窦病变引起眶尖综合征患者的临床资料，分为手术组21例，保守组35例，比较两组的临床特征及预后。 结果：鼻窦病变中手术组真菌性鼻窦炎占61.9%，细菌性鼻窦炎占28.6%，蝶窦肿瘤占9.5%。保守组非真菌性鼻窦炎占65.7%，真菌性鼻窦炎占34.3%。除鼻窦病变外，患者合并有基础疾病，手术组中高血压占71.4%，糖尿病占80.9%；保守组中高血压占28.6%，糖尿病占42.9%。随访1个月~5年，手术组症状改善率为85.7%，复发1例，再次手术后未见复发；而保守组症状改善率为22.9%，症状改善后再复发6例，转至鼻科手术后未见复发。 结论：本研究中鼻窦病变多为真菌性鼻窦炎，此外，合并糖尿病、高血压、肾病综合征等基础疾病的患者鼻部免疫力下降，显著增加了发病风险。由于早期鼻部症状不明显，多学科合作诊疗十分必要。影像学检查一旦提示为鼻窦病变引起的眶尖综合征，需尽早进行鼻内镜下鼻窦开放术。.
摘要：
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