鼻窦显微手术与中鼻道开窗术

SINUS MICROSURGERY AND MIDDLE NASAL MEATAL ANTROSTOMY

分析了222例、359侧慢性鼻窦炎、鼻息肉鼻窦显微手术与52侧中鼻道开窗术的疗效,288侧随访1～4年,平均36.4个月,良好率为67.71%,与术后3年的远期疗效比较,鼻内筛窦手术良好率为60.63%(77/127),经上颌窦手术为72%(108/155);上领窦窦口扩大未闭率为60.42%(58/96),中鼻道开窗未闭率为92.16%(47/51);两组差异均有显著性(P<0.005)。并发症为7.52%(27/359),与筛窦手术有关者占3.9%(14/359),无严重或致死并发症。对影响疗效的因素、手术类型选择、中鼻道开窗方式、并发症预防作了讨论与分析。作者强调对复发性全副鼻窦炎与鼻息肉,以经上颌窦手术及中鼻道开窗术为好。

Three hundred and fifty-nine sinus microsurgery and 52 middle nasal rneatal antrostomy was analysed with chronic sinusiets and polypi. A 1～4 years follow-up (average36.4 months)of 288 was progressed,the good cure rate was 67.71%. Analysed the effect of cure result over 3 years, the good cure rate of intranasal ethmoideetomy was 60. 63% (77/ 127), of transmaxillary sinus surgery 72%(108/155). The patency rate of ostiurn enlargement of the maxillary sinus was 60.42% (58/96),of middle nasal meatal antrostomy 92. 16%(47/51). The difference in two forms was significant (P<0. 005), surgery complication was 7. 5%(27/359), related with ethmoid sinus 3. 9%(14/359). The influential factor of curative effect,the selection of surgical kind, the technique and method of middle nasal meatal antrostomy, and the prophlaxis of the complication with sinus surgery was discussed and analysed. The authors stressed that the transantral surgery with the middle nassl meatal antrostomy was a better kind for recurve all sinusietis and polypi.