鼻内窥镜手术中避免窦口鼻道复合体粘连和闭塞的认识

The prevention and cure about adhesion and occlusion of ostiomeatal complex in nasal endoscopic surgery

目的 探讨鼻内窥镜手术中窦口鼻道复合体粘连和闭塞的原因和防治方法。方法 对本科完成的鼻内窥镜手术266例511侧 ,进行随访检查 ,重点观察窦口鼻道复合体粘连和闭塞的情况。 结果 术后出现术腔粘连124侧 ,其中中鼻甲与鼻腔外侧壁粘连106侧 ,中鼻甲与下鼻甲粘连65侧 ;发现术腔闭塞62侧。 结论 窦口鼻道复合体粘连和闭塞的主要原因是钩突切除不完整、过份强调保留病变的中鼻甲和过多地损伤中鼻甲基板以及术后未能在鼻内窥镜下及时清除术腔复发的病变组织。

Objective To explore the reason and method of prevention and cure about adhesion and occlusion of ostiomeatal complex in nasal endoscopic surgery. Methods 266 patients(511 nasal cavity sides) undergone nasal endoscopic surgery were followed-up. The adhesion and occlusion of ostiomeatal complex was observed emphatically. Results 124 sides of adhesion and 62 sides of occlusion in ostiomeatal complex were found Adhesion between middle turbinate and outer wall of nasal cavity was 106 sides. Adhesion between middle turbinate and inferior turbinate was 65 sides. Conclusion The main reason for adhesion and occlusion of ostiomeatal complex were that uncinate process was not removed wholly, middle turbinate of pathological changes was remained too much, of middle turbinate was severe injured during operation and the reborn ill tissue in nasal cavity with endoscopy post operatively were not clean out.