鼻内窥镜手术中的轮廓化问题

The Experiences of Rhinoplasty in Endoscopic Sinus Surgery

目的探讨鼻腔轮廓化的方法与效果。方法回顾性分析行鼻腔轮廓化109例患者的临床资料,其中下鼻甲肥大16例,中鼻甲肥大14例,中、下鼻甲均肥大35例,鼻中隔偏曲17例,下鼻甲肥大合并鼻中隔偏曲16例,泡状中鼻甲合并鼻中隔偏曲6例;鼻中隔偏曲同时伴有下鼻甲肥大及泡状中鼻甲5例。83例鼻腔或中鼻道见息肉样组织。先在鼻内镜下分别行鼻腔息肉切除,鼻中隔偏曲矫正、下甲外移或部分粘膜下骨切除、中甲部分切除后,再行鼻窦开放手术。结果经鼻腔轮廓化后,鼻窦手术视野扩大,操作顺利。术后5例失访,其余均随访满6个月。除1例鼻腔通气不佳外,余术后鼻腔均清理方便、通气满意。89例窦口上皮化良好;10例窦口不畅;5例复发。结论通过鼻内镜行鼻腔轮廓化后再行鼻窦手术,视野宽阔,操作方便,术后清理方便,使鼻窦炎手术效果更佳。

Objective To investigate the clinical methods and effect of rhinoplasty in endoscopic sinus surgery. Methods 109 cases underwent rhinoplasty in endoscopic sinus surgery was reviewed. The causes of rhinoplasty were as follows： inferior turbinate hypertrophy in 16, middle turbinate hypertrophy in 14, inferior and middle turbinate hypertrophy in 35, septal deviation in 17, inferior turbinate hypertrophy combined with septal deviation in 16, concha bullosa combined with septal deviation in 6, and septal deviation combined with inferior turbinate hypertrophy and concha bullosa in 5. Polyps were founded in nasal cavities or middle nasal meatus in 83 patients. Results After rhinoplasty, visual field was enlarged and operations were performed smoothly. 105 cases were followed up for 0.5 years. 89 cases were achieved ostiums epitheli- alization well, 10 cases were performed reoperations for apertures obstruction, and 5 cases relapsed. Con- clusions Rhinoplasty is beneficial to widen the surgery field commodiously, accomplish the operation conveniently, and clear the nasal cavity swimmingly. Thus, it can achieve to a better operative effect for sinusitis in endoscopic sinus surgery.