摘要
目的改进鼻内镜下的额窦开放手术,提高额窦炎的治愈率。方法显微镜下观察10例解剖标本的钩突位置,并测量鼻丘的大小,结合39例(61侧)复发性慢性额窦炎患者鼻窦CT扫描结果进行分析,采用鼻内镜下经上颌骨额突-鼻丘径路额窦开放术式,对上述患者进行额窦开放术。结果10例(18侧)标本鼻丘气房的前后径、左右径和高度分别为(5.6±1.3)mm、(4.1±1.1)mm和(6.2±2.5)mm,所有钩突均附着于上颌骨额突及中鼻甲骨与额突的交界处,上端单纯附着于眶纸板14侧(70%),单纯附着于颅底3侧(15%),交叉附着于眶、颅底或中鼻甲3侧(15%)。CT扫描结果显示,慢性额窦炎复发与鼻丘气房未完全切除相关(P<0.001)。39例患者经改进的术式治疗后,治愈率为90.2%。结论额窦开口周围的钩突和鼻丘气房变异大,鼻丘气房清除不彻底可能是慢性额窦炎复发的主要原因,鼻内镜下经上颌骨额突-鼻丘径路额窦开放是治疗复发性慢性额窦炎的有效方法。
Objective To improve the skills and therapeutic effects of the nasal endoscopic frontal sinus surgery. Methods The location of the uncinate process was observed and the size of agger cells was measured under operational microscope in 10 anatomic specimens. The CT films were analyzed in 39 cases with recurrent chronic frontal sinusitis. Nasal endoscopic frontal sinus surgery through the approach of maxillary frontal process-agger nasi was carried out in all the 39 cases. Results The length, width, height, were （5. 6±1.3） mm, （4. 1±1. 1） mm, and （6. 2±2. 5） mm, respectively. 70% of the anterior-upper uncinate process was found attaching to the lamina papyracea, and 15% to the skull base, and 15% crossly to the lamina papyracea and skull base or middle turbinate. The analysis of CT scan showed that the recurrence of chronic frontal sinusitis was associated with the residue of agger cells （ P 〈0. 005）. The cure rate was 90. 2% in 39 patients who underwent themodified endoscopic surgery. Conclusion There are extensive varieties in uncinate process and agger nasal cells around the nasal frontal canal. The residue of agger cells may be a major cause of the recurrence of chronic frontal sinusitis. Nasal endoscopic frontal sinus surgery through the approach of maxillary frontal process-agger nasi is an effective method to treat the recurrent chronic frontal sinusitis.
出处
《中国耳鼻咽喉颅底外科杂志》
CAS
2007年第4期265-268,共4页
Chinese Journal of Otorhinolaryngology-skull Base Surgery
关键词
额窦炎
复发性
鼻内镜术
Frontal sinusitis
Recurrence
Endoscpe
