复发性鼻息肉的鼻内窥镜修正术

Revision endoscopic sinus surgery for recurrent nasal polyps

目的 :探讨鼻内窥镜修正术治疗复发性鼻息肉的疗效和手术体会。方法 :回顾分析 1997年 7月～ 1998年 10月间 2 1例因鼻息肉复发在我院行鼻内窥镜修正术的患者 ,2 1例均双侧同时手术 ,根据 CT所见及术中情况 ,采用筛窦全切或次全切 ,上颌窦自然窦口扩大 ,尖牙窝径路上颌窦病变组织清除等手术方式。结果 :随访 6～12个月评定疗效 ,治愈 7例 ,好转 8例 ,无效 6例 ,总有效率 71.4% ,无一例出现严重并发症。结论 :鼻内窥镜修正术治疗复发性鼻息肉疗效较好。 May等提出的鼻腔中 6个解剖标志对彻底清除病变组织 ,提高手术疗效 ,防止严重并发症颇有裨益。

Objective:To study the surgical effect and experience of revision endoscopic sinus surgery for the patients with recurrent nasal polyps.Method:From Jul.1997 to Oct.1998,a subset of 21 cases with recurrent nasal polyps had been operated by the way of revision endoscopic sinus surgery.All the patients were operated bilaterally at the same time.The operation type included:total ethmoidectomy or sub total ethmoidectomy,maxillary natural orifice enlargement and maxillary sinus pathological changes tissue eliminated by canina fossa access.Result:We have followed these patients for 6～12 months and evaluated surgical effect:7 cases of 21 were cured,8 were improved,6 were of no effect,and the total effective rate was 71.4% .There are not any heavy complications in this subset.Conclusion:Revision endoscopic sinus surgery is an effective way for recurrent nasal polyps patients,six anatomic marks proposed by May will do good for us to resect the pathological changes tissue thoroughly and prevent heavy complications as could as possible.