鼻内窥镜手术中对上颌窦自然开口的处理疗效观察

The Management of the Ostia of the Maxillary Sinus in Endoscopic Sinus Surgery

目的探讨功能性鼻窦内窥镜手术治疗时上颌窦自然开口的处理与否对其疗效的影响程度。方法80例慢性鼻窦炎鼻息肉患者随机分成两组,治疗组40例,清除中鼻道病变及异常结构不扩大上颌窦自然开口。对照组40例术中切除中鼻道病变及异常结构的同时扩大上颌窦自然开口。术后随访1年以上。结果窦口的开放率在不扩大和扩大上颌窦自然开口分别为92.5%和75%,治疗组治愈率90%,对照组治愈率73%,两组病例差异有显著性意义(P<0.01)。结论慢性鼻窦炎及鼻息肉手术中主要清除窦口周围异常结构及病变,上颌窦自然开口如无明显狭窄不必扩大。

Objective To ivestigate the role of treatment of maxillary ostia in functional endoscopic sinus surgery and to observe the curative effect. Method 80 cases of chronic maxillary sinusitis and nasalpoyp were treated with FESS and followed up for over one year, which were divided into two groups randomly. The ostia of maxillary was broadened in the therapy group, while it was not managed in the control group. Result The patency rates of the maxillary ostia in patients with enlarged and unchanged maxillary ostia were 92 .5% and 75% respectively. The cure rate of the therapy group was90%, and the one of the control group was 73%.There was significant difference（P〈0. 01）.Conclusion It is unnecessary to broaden the ostia of the maxxillary in endoscopic sinus surgery, if ostia of the maxillary sinus have no stricture apparently.