鼻内镜额窦手术56例分析

Experiences of nasal endoscopic frontal sinus surgery with a report of 56 cases

目的探讨鼻内镜下额窦手术的方法。方法总结56例鼻内镜下额窦手术,其中额窦炎症性病变54例,额窦囊肿2例。术前通过CT检查判定额窦结构,尤其是额隐窝和钩突的解剖特点,术中在鼻内镜下准确定位额窦开口,清除或纠正额窦开口及其周围结构病变或变异,建立良好的符合生理需求的额窦引流通道。结果术后随访6～18个月,全部病例症状消失或改善,无1例复发,无术后严重并发症。结论功能性鼻内镜下额窦手术不失为一种安全、有效及微创的手术方式,适用于大多数额窦病变,术前CT阅片及术中对解剖结构的辨认至关重要。

[Objective] To discuss a more effective approach of nasal endoscopic frontal sinus （FS） surgery in the treatment of FS diseases. [Methods] 56 eases of endoscopic FS surgery during 2005 and 2007 were retrospectively studied, which were performed in 54 cases of chronic frontal sinusitis and polyps, and in 2 eases of FS cyst. The anatomic characters of the FS and the different types of the attachment of uneinate process were confirmed preoperatively by CT examination, thus a more effective and physiological drainage was established for FS. [Results] After the operation, the symptoms of all the patients disappeared or improved, the results of endoscopic examination showed satisfying epitheliumization and the orifices of the FS were smooth and unbloeked. During the follow-up of 6 to 18 months no post-operative recurrence and severe complications were found. [ Conclusion] Nasal endoscopic FS surgery is a safe, effective, minimally-invasive surgical procedure and is suitable for most FS diseases. The pre-operative CT study and the distinguishing anatomic structure are of vital importance.