鼻内镜手术治疗额窦病变

Endoscopic surgery for frontal sinus diseases

目的探讨经鼻内镜手术治疗额窦病变的方法及疗效。方法经CT明确诊断的额窦病变33例（56侧）,以CT扫描成像为基础在鼻内镜下以鼻丘气房、钩突附着上缘及筛泡前上缘为标记开放额隐窝及额窦。结果所有手术最终找到并开放额窦,无严重并发症发生。术后鼻内镜检查,随访3~18个月。27侧痊愈,额窦口开放引流良好,炎症全部消失;21侧有效,症状明显改善;8侧无效。结论经鼻内镜手术治疗额窦病变应密切参考CT扫描影像,准确定位额窦口。去除额隐窝处病变,充分开放额窦口引流是治疗额窦病变的关键。

Objective To assess the methods and efficacy of endoscopic surgery for frontal sinus diseases. Methods Thirtythree patients（56 cases）with frontal sinus diseases were involved in this study. With the foundation of HRCT, drainage passage and ostium of the frontal sinus were identified and opened through the landmark of agger nasi cells, the superior attachment of the uncinate process and the anterosupterior basal lamella of the bulla. Results The ostium of the frontal sinus was identified in all patients without serious complications. All patients were followed up by endoscopy for 3 to 18 months. Among them, 27 cases were cured,21 cases were effective and 8 cases were ineffective. Conclusion HRCT scan is a basic landmark for endoscopic surgery to identify the ostium of the frontal sinus. Removing the frontal recess lesions and keeping drainage passage of the frontal sinus are key points to cure frontal sinus diseases.