鼻内镜术后影响上颌窦口引流的相关因素分析

Analysis of the draining state of maxillary sinus treated by endoscopic sinus surgery and its influence factors

目的探讨鼻内镜手术后影响上颌窦口引流状况的相关因素。方法通过鼻内镜治疗鼻窦炎256例,根据窦口形态和上颌窦本身病变情况,决定不同处理方法,从而探讨影响上颌窦狭窄闭锁的原因。结果 256例患者经过术后6个月随访,窦口开放率80.5%(206/256),狭窄率9.0%(23/256),闭锁率10.5%(27/256),影响上颌窦口引流常见四个因素:是否伴息肉,窦口自然开放方式、窦口处理方式和术后随访情况。结论上颌窦口是否开放是内窥镜鼻窦手术疗效及评定的重要依据,正确处理上颌窦口,特别保留后下方粘膜及术后按时随访是保证窦口长期开放的关键。

Objective To explore the draining state of maxillary sinus treated by endoscopic sinus surgery （ESS） and its influence factors. Methods 256 patients with chronic sinusitis were treated by endoscopy. Different operation mode was depended on the shape of the ostium and the maxillary sinus disease. The reason caused ostium maxilare paro- chialism or atresia were observed. Results 256 patients of chronic sinusitis should be followed up for 6 months after ESS. The patency rate of maxillary ostia was 80.5 % （206/256）, parochialism rate was 9.0% （23/256）, and atresia rate was 10.5% （27/256）. There were four factors influencing the draining state of sinusitis., chronic sinusitis with nasal polys or without nasal polys, the shape of ostium, operationg mode and regular follow-up after ESS. Couclusion The pa- tency of maxillay ostia is an important basis for evaluating the effectiveness of ESS. Accurate management of the ostium during the operation, especially the posterior part of inferior edge was reserved,and regular follow up after the operation are the key point to assure the long -term patency of ostia.