摘要
鼻内镜手术是鼻科手术的里程碑,而计算机辅助导航鼻内镜手术则是鼻科又一个里程碑。笔者所在科室自2005年采用美敦力光学导航行导航辅助鼻内镜手术近2000例。本文重点讨论导航辅助鼻内镜下复发性鼻窦炎全组鼻窦开放策略。首先是术前需要拍摄鼻窦导航CT,行导航般阅片,对鼻窦按改良Lund-Mackay方法评分,对额隐窝各种气房进行识别,分析额窦引流通道,按High CLOSE方法对鼻窦及周围重要解剖标志进行严密阅片,然后按术前导航般阅片制定手术策略,术中在导航引导下按术前影像分析,按着解剖标志逐一开放全组鼻窦。导航辅助鼻内镜手术是在有扎实的解剖学基础,有导航般阅片能力基础上使用的。计算机辅助导航系统的应用可以让医师更好的对复发性鼻窦炎行全组鼻窦开放术。
Endoscopic endonasal surgery is the milestone for rhinologic surgery, but computer assisted endoscopic surgery （CAS） is another milestone for rhinologic procedures. We have done CAS rhinologic procedures near 2000 cases with Medtronic CAS workstation from 2005. We mainly discuss CAS assisted endoscopic full house FESS for recurrent chronic rhinosinusitis. The first step is to do navigation sinus CT scan for the patient and do navigator reading to the sinus scan, do modified Lund-Mackay score, recognize frontal recess cells and make a clear analyses for frontal sinus pass way. Do High CLOSE reading to the sinus scan and remember all critical landmarks of all sinus and surrounding structures. Make surgery plan according preoperative CT reading. Open the whole house according preoperative sinus CT reading and intraoperative navigation. Anatomic and preoperative image study is the basis for the use of CAS in the sinus operation, and it is safe to do the recurrent whole FESS with the CAS.
出处
《中国医学文摘（耳鼻咽喉科学）》
2014年第4期197-200,共4页
Chinese Medical Digest(Otorhinolaryngology)
