小钻孔鼻内双入路内镜下额窦开放术的临床价值研究

发布时间：2018-03-05 23:16

本文选题：额窦炎　切入点：内镜检查　出处：《临床耳鼻咽喉头颈外科杂志》2014年08期 　论文类型：期刊论文

【摘要】：目的:探索小钻孔、鼻内双入路内镜下额窦开放术的临床价值。方法:根据术前鼻内镜及CT检查结果进行评估,挑选术中可能出现引流通道识别困难的26例慢性额窦炎患者进行研究。双入路组11例(13侧),采用小钻孔、鼻内双入路内镜下额窦开放术,首先在额窦前壁钻直径4~5mm骨孔,通过注水冲洗、光照、顺行法放入导管等方法显示额窦引流通道位置,经鼻内、鼻外双入路行额窦开放术;鼻内镜组15例(18侧),常规行鼻内镜下额窦开放术,采用Friedman的"钩突径路"术式。术后定期随访处理。结果:双入路组均顺利找到额窦开口,完成额窦开放,无手术并发症;鼻内镜组出现眶纸板损伤2例,筛前动脉损伤1例。随访10~24个月,双入路组额窦口通畅11侧(85%),狭窄2侧;鼻内镜组通畅15侧(83%),狭窄3侧;两组均无完全堵塞者。结论:前壁小钻孔、鼻内双入路内镜下额窦开放术治疗慢性额窦炎安全性高,疗效好,可提高术者对额窦引流通道解剖认知水平及额窦手术技能,值得在基层医院推广。
[Abstract]:Objective: To explore the small hole in the nose into the double way endoscopic frontal sinus surgery. Methods: according to the clinical value of preoperative nasal endoscopy and CT examination results were evaluated, drainage occurred in 26 cases of chronic frontal sinusitis patients with channel identification difficult research may choose surgery. Two incision group and 11 cases (13 sides). The small hole in the nose, two incision endoscopic frontal sinus surgery, first diameter 4~5mm bone holes drilled in the frontal sinus, through water washing, light, and other methods of antegrade catheter into the frontal drainage channel position display, nasal, nasal double approach for frontal sinus surgery; Nasal Endoscopy Group 15 cases (18 sides), underwent endoscopic frontal sinus surgery with Friedman "uncinate process path" operation. Regular follow-up after operation. Results: the two incision group were successfully found sinus ostium, completed without complications; frontal sinus, nasal endoscopy group had 2 cases of orbital trauma, anterior ethmoid arterial injury 1 Patients were followed up for 10~24 months, two incision group frontal sinus patency in 11 side (85%), 2 narrow side; endoscopic group patency in 15 side (83%), 3 narrow side; two were completely blocked. Conclusion: the anterior wall of the small hole in the nose, two incision endoscopic frontal sinus surgery treatment chronic frontal sinusitis with high safety, good curative effect, can improve the operation of frontal sinus drainage anatomy and cognitive level of frontal sinus surgery skills, worthy of promotion in the primary hospital.

【作者单位】：广州市番禺区中心医院耳鼻咽喉科;
【基金】：广州市医药卫生科技项目(No:201102A213062) 番禺区科技计划项目(No:2011-Z-03-52)
【分类号】：R765

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