鼻内镜下治疗额窦炎38例

Endoscopic sinus surgery for frontal sinusitis

目的通过鼻内镜下开放额窦口治疗额窦炎性病变。方法38例患者术前常规鼻窦CT证实有额窦炎性病变。根据CT扫描以钩突附着为参考标志,判断额窦引流方式,以其进行额窦口开放引流。结果38例患者均为额窦口阻塞,原因分别为额窦口被肿胀黏膜、息肉样变黏膜和过度发育气房阻塞,额窦引流受阻引发额窦炎。术后随访6个月至18个月,治愈22例,好转9例,复发7例。结论额窦炎性病变主要原因是额窦口引流受阻,为额隐窝及窦口鼻道复合体处病变阻塞所致。鼻内镜下充分开放额隐窝,去除额隐窝处病变,充分开放额窦口引流是治疗额窦炎的关键问题。

OBJECTIVE To assess the efficacy of endoscopic frontal sinus surgery for frontal sinusitis. METHODS Thirty eight patients with chronic frontal sinusitis were involved in this study. All of the patients were diagnosed by CT before operation. The drainage passage of frontal sinus was judged by CT scan. RESULTS Obstruction of frontal sinus ostium was found in all cases. The frontal sinus ostia were obstructed by swelling mucosa,polypoid mucosa or over developed cells. Twenty two cases were cured,17 cases better and 7 cases recurred after following up for 6 to 18 months. CONCLUSION Frontal sinus ostium obstruction （most of the obstruction located in the ostiomeatal complex and frontal recess） is the main cause of the frontal sinusitis. Nasal endoscopic surgery is a good method for management of chronic frontal sinusitis with minimal trauma.