鼻内镜手术中病变中鼻甲的处理

Management of pathological middle turbinates in endoscopic sinus surgery

目的 :探讨鼻内镜手术对病变中鼻甲处理方法与慢性鼻窦炎Ⅱ型 2、3期手术疗效及鼻功能恢复之间的关系。方法 :按摒弃Ⅰ型Ⅱ型 1期及Ⅲ型病变的原则分组 ,为 2 14例慢性鼻窦炎Ⅱ型 2、3期患者行功能性鼻内镜手术。依中鼻甲病变程度行中鼻甲下缘激光烧灼 ,中鼻甲外侧部矢状切除及外侧部加下部部分切除术。结果 :术后 3～ 6个月中鼻甲形态基本恢复正常 ,无 1例发生鼻腔粘连 ,慢性鼻窦炎Ⅱ型 2、3期的治愈好转率 86 4%。结论 :对慢性鼻窦炎Ⅱ型 2、3期患者 ,在术中酌情处理病变中鼻甲 ,既防止鼻腔粘连的发生 ,形成一个开放的窦口 鼻道通气引流系统 ,缩短换药时间 ,提高治愈好转率 ,又符合人体鼻腔生理。

Objective To explore the relationship between the results of endoscopic sinus surgery and nosal functional recovery.Methods Two hundreds and fourteen patients with sinusitis and nasal polyps were chosen.According to the pathological changes,the middle turbinates were burnt with laser or partial resected.Results The normality of middle turbinate was recovered basically in 3～6 months.There was no synechia in those with partial middle turbinectomy.The efficiency of chronic sinusitis was 86.4%.Conclusion The suitable management of pathological middle turbinates suitable in the endoscopic sinus surgery may be good for the prognosis of patients with chronic sinusitis. [