翼管神经切断术治疗过敏性鼻炎的探讨

Treatment of allergic nasitis with neurectomy of pterygoid canal

目的 :为探讨治疗顽固性过敏性鼻炎的有效方法及快速寻找和确定翼管神经的简便途径。方法 :对 2 3例 (46侧 )严重的过敏性鼻炎患者采用 Caldwell- L uc法进入上颌窦 ,手术显微镜下于上颌窦后壁内上 1/3处切开后壁进入翼腭窝 ,找出蝶腭神经节作为标志 ,在其深层寻找翼管神经并切断之 ,以治疗过敏性鼻炎 ,观察术后鼻涕、鼻塞、打喷嚏、鼻痒和泪液分泌情况。结果 :2 3例近期效果达 10 0 % ,经 5 a～ 8a随访 ,3例复发 (复发率为 13% ) ,远期疗效为 87%。结论 :翼管神经切断术对治疗顽固性过敏性鼻炎有较好疗效。

Objective:This procedure was designed to treat the stubborn allergic nasitis,and expected to determine the position of nerves of pterygoid canal by simple way.Methods:23 patients were operated from 1992 to 1995,Caldwell-Luc approach to the maxillary sinus and removal of the posterior above and medial 1/3 bony well of sinus to pass into pterygopalatinus,exposed maxillary arterial,maxillary nervous node,nerves of pterygoid canal,and cuted it.Results:The effect of 23 cases was 100 % in short-term.Forrow-up from five years to eight years,3 patients recurred,the effect was 87 % in long-term.Conclusion:The neurectomy of pterygoid canal was quite effective for stubborn allergic nasitis.