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台耳醫誌

雜誌專區 -第59卷第4期

病例報告 
Utilization of Computer-Assisted Navigation System in Endoscopic Resection of Primary Sinonasal Mucosal Melanoma with Orbital Invasion  僅供有效會員 登入會員查看全文
171~177 
英文 
melanoma、computer-assisted navigation system、endoscopic sinus surgery、orbit、黑色素瘤、電腦導航系統、內視鏡鼻竇手術、眼窩 
Peng Yeh1 、Li-Jen Liao1,2,3 、Kai-Min Fang1,4  
Department of Otolaryngology, Far Eastern Memorial Hospital, New Taipei City1 、Head and Neck Cancer Surveillance and Research Study Group, Far Eastern Memorial Hospital, New Taipei City2 、Department of Electrical Engineering, Yuan Ze University, Taoyuan City3 、Department of Nursing, College of Healthcare and Management, Oriental Institute of Technology, New Taipei City4  
Primary sinonasal mucosal melanoma (SNMM) is a rare malignancy. The mainstay treatment of primary SNMM is surgical excision with or without adjuvant radiotherapy. However, clear margin is sometimes difficult to achieve due to considerable destruction of surrounding structures. The utilization of computer-assisted navigation system (CANS) ensures safety during surgery. A 63-year-old female came to our hospital due to progressive right orbital fullness and diplopia for 2 weeks. Magnetic resonance imaging with gadolinium enhancement documented a right sinonasal tumor invading the right ethmoid sinus, right maxillary sinus, and right conal space. Transnasal endoscopic tumor excision was performed with the aid of CANS. Histopathological and immunophenotypic analysis showed primary SNMM. The patient received subsequent dacarbazine chemoradiotherapy. Follow-up sinoscopic examination six months after surgery showed good wound healing and disease status. (J Taiwan Otolaryngol Head Neck Surg 2025; 59:171-177)
原發性鼻腔鼻竇黏膜惡性黑色素瘤為少見的惡性腫瘤。雖然並無明確治療指引，原發性鼻腔鼻竇黏膜惡性黑色素瘤的治療以手術切除為主。然而，原發性鼻腔鼻竇黏膜惡性黑色素瘤為常侵蝕周圍構造導致完整切除之困難。電腦輔助導航系統的應用可提升手術安全。一位63歲女性因 右側眼窩腫脹合併複視兩週至本院就診，磁振攝影檢查發現一原發於右側鼻腔鼻竇的浸潤性腫瘤，伴有右眼眶內側壁、右側篩竇和右側上頷竇的骨質破壞。在導航系統的輔助下，進行經鼻內視鏡鼻腔鼻竇腫瘤切除手術，病理檢驗證實為鼻腔鼻竇黏膜惡性黑色素瘤。患者後續接受了數輪的同步化學放射治療，治療反應良好。（台耳醫誌　2025; 59:171-177） 
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