改良鼻丘入路额窦手术方式分析

Modified agger nasi approach in the endoscopic frontal sinus surgery for frontal sinus lesions

目的探讨鼻内镜下额窦病变的改良鼻丘入路手术方式。方法选择2010年2月～2011年5月在我院行鼻内镜下额窦开放术的106例(155侧)患者,随机分为2组,经改良鼻丘入路额窦开放术56例(85侧),以钩突为主要参考标志的鼻内镜下额窦开放术50例(70侧)。结果两组患者随访6～12个月,平均9个月,鼻内镜下评价:鼻丘入路组疗效优于钩突入路组,有效率分别为97.65%和88.57%,两组比较有显著差异(χ2=5.24,P<0.05);CT评价:鼻丘入路组疗效优于钩突入路组,有效率分别为97.65%和84.29%,两组差异有统计学意义(χ2=8.92,P<0.05)。结论鼻内镜下改良鼻丘入路治疗额窦病变的手术方式,可获得较满意的疗效,值得临床推广。

OBJECTIVE To investigate the modified agger nasi approach in the endoscopic frontal sinus surgery for frontal sinus lesions. METHODS A hundred and six patients（155 sides）who underwent endoscopic frontal sinus surgery from February 2010 to May 2011 were divided into two groups. In one group, agger nasi approach was used in 56 patients（85 sides）, and in the other group, uncinate process approach was used in 50 patients（70 sides）. RESULTS All the patients were followed up 6 to 12 months（mean 9 months）. Through endoscopic evaluation： 97.65% patients were cured by the agger nasi approach, 88.57% patients were cured by the uncinate process approach, and there was significant difference between the two groups（χ 2 =5.24, P 〈0.05）. CT evaluation： 97.65% patients were cured by the agger nasi approach, 84.29% patients were cured by the uncinate process approach, and there was significant difference between the two groups（χ 2 =8.92, P 〈0.05）. CONCLUSION The modified agger nasi approach was effective in the endoscopic frontal sinus surgery for frontal sinus lesions and worth to popularize the application.