近发际缘内头皮冠状切口径路在耳鼻咽喉头颈外科手术中应用的临床意义

Applicaiton of near hairline coronal incision in otolaryngology and head and neck surgery

目的探讨近发际缘内头皮冠状切口手术径路在耳鼻咽喉头颈外科手术中的临床意义。方法采用经近发际缘内头皮冠状切口入路,行颧骨复合体骨折切开复位内固定术20例;额窦巨大囊肿4例;额窦骨瘤2例;额部良性肿块2例,分析、观察总结此切口的优缺点。结果 28例疗效满意,所有切口均Ι期愈合,无面部切口瘢痕遗留、术后面神经瘫痪、脑膜撕裂脑脊液漏出现。结论近发际缘内头皮冠状切口手术入路,在颅脑及颌面外科经常使用。在耳鼻咽喉头颈外科手术中应用此切口,术野显露充分,对比颜面部中上份一些传统入路难以操作的手术更方便,更能提高手术质量。直视下的手术能避免在该区域手术操作中的面神经损伤脑膜损伤脑脊液鼻漏的并发症,同时也隐藏了颜面部的手术切口瘢痕达到术后面部美观之功效。该切口是面中上份手术切口径路的理想选择,值得在耳鼻咽喉头颈外科手术中应用推广。

Objective To explore the application of near hairline coronal incision in otolaryngology and head and neck surgery. Methods Totally, 28 patients were operated with near hairline corona/incision, including 20 internal fixation of zygomatic complex fracture, 4 frontal sinus cyst excision, 2 frontal sinus osteoma excision and 2 frontal benign tumor excision. Results All the 28 cases achieved satisfying curative results with primary wound healing. No facial scar, facial nerve paralysis or cerebrospinal fluid leakage occured after the operations. Conclusion The near hairline coronal incision is frequently applied in craniocerebral and maxillofacial surgery. The operative view is also sufficient for otolar- yngology head and neck surgery. Compared with traditional approaches, it is more convenient for some upper or middle facial operations and can improve the quality of operation. Moreover, direct vision can avoid the complications, such as facial nerve injury and cerebrospinal fluid rhinorrhea. Meanwhile, it can effectively avoid the incision-related scar in conventional facial operations. In conclusion, this approach warrants the wide application in otolaryngology head and neck surgery.