眼眶周圍腫痛 黴菌性鼻竇炎作怪Orbital swelling and pain around the fungal sinusitis mischief

眼眶周圍腫痛 黴菌性鼻竇炎作怪 【中央社】兩名婦女因眼眶周圍腫痛，一直以為是眼睛出毛病，到處看醫師，最後腫痛難耐，到澄清醫院檢查才發現其中一名是黴菌性鼻竇炎，另一名是篩竇部位長了骨瘤。台灣台中市澄清醫院耳鼻喉科主治醫師王弘毅表示，黴菌性鼻竇炎延誤治療，嚴重時有可能導致失明。 王弘毅表示，一名五十歲的女性患者，兩個月來，發現自己的右眼眶周圍腫痛，有時會牽扯痛到頭部，到眼科求診認為非眼睛引起的疼痛，又看了腦神經科也認為不像是單純的神經痛，吃了一段時間消腫止痛的藥仍不見改善，因腫痛加劇而掛急診，經電腦斷層發現鼻竇有腫脹發炎現象，立即會診耳鼻喉科。 王弘毅指出，這名患者並未有明顯的鼻蓄膿或鼻塞情形，進一步以鼻腔內視鏡檢查，發現患者的鼻腔黏膜有息肉樣變化，最後診斷為黴菌性鼻竇炎。因為鼻竇接近眼眶及頭底部位，會牽引到眼部痛和頭痛，若黴菌性鼻竇炎的發炎狀況持續下去，眼眶周圍的骨頭會受到侵蝕，等到黴菌跑到眼睛去，就可能造成眼眶的蜂窩性組織炎，或是眼睛的蓄膿，嚴重還會導致失明。 王弘毅說，一般鼻竇炎以細菌感染為主；黴菌性鼻竇炎比較特殊，而且通常發生在單側為主，患者常常感覺眼部痛、頭痛。如果黴菌性鼻竇炎不明顯，患者都會往眼睛的疾病求醫。 另一名四十歲的婦女，也是因單側眼眶周圍腫痛求醫，經電腦斷層檢查，發現在患者的篩竇部位有一顆約一公分大的高密度腫塊，開刀切除並化驗證實是良性的骨瘤。 王弘毅表示，鼻竇炎引起的疼痛有原發處疼痛，例如額頭、臉頰及眼眶周圍，另一種是轉移痛，例如牙齒、頭部側邊、頭頂及後腦勺疼痛，這些部位最容易被混淆或誤診。而因篩竇部位的骨瘤，則是因骨瘤壓迫到眼眶附近的神經，才引起眼眶的腫痛。 2008-09-15 Orbital swelling and pain around the fungal sinusitis mischief [CNA] two women because of swelling and pain around the eyes, always thought that the eye Chu Maobing everywhere to see doctors, the final swelling and pain intolerable, to clarify the hospital for an examination found that one of the fungal sinusitis, and the other is the ethmoid Parts of the osteoma. Taiwan's Taichung Hospital ENT clarify Dr. Wang Hongyi said that delays in treatment of fungal sinusitis, it may lead to serious blind. Wang Hongyi, a 50-year-old female patient, the past two months, found themselves the right orbit around the swelling and pain, sometimes involves pain to his head, eye to eye that non-attendance caused pain, read the brain Neurologists also think that unlike a simple neuralgia, eat for a period of time swelling pain medicine is still not improved, but because of swelling and pain linked to increased emergency room, CT found a swollen sinus inflammation, ENT consultation immediately. Wang Hongyi pointed out that the patients do not have obvious nose with pus or stuffy nose circumstances, to further nasal endoscopy found in the nasal mucosa have polypoid changes, the final diagnosis of fungal sinusitis. Because the orbital and sinus close to the end of the first part, will traction to the eye pain and headache, if the fungal sinusitis inflammatory situation continues, the orbital bones around will be eroded, to wait until the mold went to the eye, may cause the orbital Yan cellular organization, or eyes with pus, can lead to serious blind. Wang Hongyi, general sinusitis to bacterial infection mainly fungal sinusitis is rather special, but usually occurs mainly in the unilateral, patients often feel eye pain, headache. If not obvious fungal sinusitis, patients with eye diseases will be to seek medical attention. Another 40-year-old women, is also due to unilateral orbit around the swelling and pain treatment, the CT scan and found that patients in the ethmoid site about one centimeter have a large mass of high-density, surgery and laboratory tests proved to be removed Healthy osteoma. Wang Hongyi said that the pain caused by sinusitis is the primary pain, such as the forehead, cheeks and eyes around, and the other is transfer of pain, such as teeth, the head side, head and Hou Naoshao pain, these parts most likely to be confused or misdiagnosed. The ethmoid part because of the osteoma, is due to orbital osteoma oppression near the nerve, before the swelling and pain caused orbit. 2008-09-15 For more information, see World Journal News ePaper.

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