复杂头颈部异物的诊治

摘要

目的 探讨复杂头颈部异物诊治的方法和临床效果.方法 回顾性分析16例在我院诊治的复杂头颈部异物患者的临床资料、诊治方法及治疗预后.结果 4例表浅部位异物中,3例顺利取出异物,1例再次手术在超声引导下取出异物;6例鼻腔、鼻窦和/或眼眶异物中,3例单纯在鼻内镜下取出异物,1例在影像导航指引下经鼻内镜取出异物,1例眶尖部异物未行手术且视力丧失,1例鼻窦颅底异物患者死亡;6例咽部或颈段食道异物中,1例误诊,1例自行穿出,2例经颈侧切开取出异物,1例形成脓肿未找到异物,1例异物发生变位经超声引导下再次手术取出异物.结论 利用现代影像技术的帮助,复杂头颈部异物的诊治都能取得比较好的效果,但应注意漏诊、误诊及防止周围重要结构的损伤.%Objective To explore the method and clinical effect of diagnosis and treatment of complex head and neck for-eign matters. Method Retrospective analysis of 16 cases with complicated head and neck foreign matters in our hospital on diag-nosis,treatment methods and prognosis. Results In the 4 cases of superficial foreign bodies,3 cases were successfully removed, and 1 case was re-operated under ultrasound guidance to remove foreign bodies. In the 6 cases of nasal cavity and sinuses and/or orbital foreign bodies,3 cases of foreign matter were removed under nasal endoscope,1 case was taken out through by the usage of navigation guidance in the nasal endoscopic,1 case where the foreign matter was in the orbital apex was performed no surgery with-in the loss of vision,and 1 case with the foreign matter in the nasal sinus died. In the 6 cases of foreign matter in the pharyngeal or cervical segment esophageal,1 case was misdiagnosed,1 case cut through by itself,2 cases were removed by the side of the neck, 1 case of abscess formation was not found foreign matter,1 case of foreign matter displacement occurred by ultrasound guided sur-gery to take out the foreign matter again. Conclusion With the help of modern imaging technology,the diagnosis and treatment of complex head and neck foreign matter can achieve better results,but it should pay attention to missed diagnosis,misdiagnosis and prevent the damage of surrounding important structures.