Background The inferior turbinate （IT） and nasolacrimal duct （NLD） are often sacrificed while managing the diffuse lesion of maxillary sinus （MS）. We report a new approach to MS without ablation of NLD and IT. M...Background The inferior turbinate （IT） and nasolacrimal duct （NLD） are often sacrificed while managing the diffuse lesion of maxillary sinus （MS）. We report a new approach to MS without ablation of NLD and IT. Methods This retrospective study enrolled 19 hospitalized patients （aged from 42 to 68 years） who underwent endoscopic sinus surgery between 2003 and 2008. Twelve patients had inverted papilloma （IP）, two had nasal polyps, two had Kubo＇s postoperative cyst of MS, one had recurrent bone cyst of maxilla, one had dentigerous cyst and one had bleeding of internal maxillary artery secondary to CaldwelI-Luc operation respectively. Two IP patients were excluded from this group since the follow-up time was less than 12 months. The NLD was dissected after removing the anterior bony portion of nasal lateral wall. The prelacrimal recess approach （PLRA） to MS was established when IT-NLD flap was raised medially. The flap was repositioned when MS lesion was removed. Results All the 17 patients had unilateral lesions. Ten MS IP patients were at the T3 Krouse stage. The follow-up ranged from 7 to 60 months. No recurrence was seen in 16 patients. Only one IP patient had a local recurrence in MS. All of them had no any complications. Conclusion The diffuse or severe diseases of MS may be the potential indications for PLRA.展开更多
目的比较不同鼻内镜下手术方法治疗变应性鼻炎(AR)伴鼻中隔偏曲的效果。方法将2014年12月至2017年1月间中山市小榄人民医院诊治的100例AR伴鼻中隔偏曲患者根据随机数表法分为观察组和对照组各50例,观察组行鼻内镜下鼻中隔黏膜下切除术...目的比较不同鼻内镜下手术方法治疗变应性鼻炎(AR)伴鼻中隔偏曲的效果。方法将2014年12月至2017年1月间中山市小榄人民医院诊治的100例AR伴鼻中隔偏曲患者根据随机数表法分为观察组和对照组各50例,观察组行鼻内镜下鼻中隔黏膜下切除术联合下鼻甲黏膜下海绵体部分切除术,对照组行常规鼻内镜下鼻中隔黏膜下切除术,比较两组患者术后1个月的疗效及并发症发生情况。结果观察组和对照组患者术后症状积分[(1.32±0.36)分vs(1.61±0.39)分]和体征积分[(1.24±0.27)分vs (1.87±0.43)分]比较,观察组均明显低于对照组,差异均有统计学意义(P<0.05);观察组和对照组患者术后糖精清除率[(16.32±2.16) min vs (17.61±2.25) min]、鼻腔阻力[(0.30±0.09) kPa/(L·s) vs (0.47±0.11) k Pa/(L·s)]比较,观察组均明显低于对照组,差异有统计学意义(P<0.05);观察组患者的治疗总有效率为94.0%,明显高于对照组的84.0%,差异具有统计学意义(P<0.05);观察组患者术后并发症发生率为2.0%,略低于对照组的10.0%,但差异无统计学意义(P>0.05)。结论鼻内镜下鼻中隔黏膜下切除术联合下鼻甲黏膜下海绵体部分切除术治疗AR伴鼻中隔偏曲可显著改善患者临床症状,效果优于单独鼻中隔黏膜下切除术。展开更多
文摘Background The inferior turbinate （IT） and nasolacrimal duct （NLD） are often sacrificed while managing the diffuse lesion of maxillary sinus （MS）. We report a new approach to MS without ablation of NLD and IT. Methods This retrospective study enrolled 19 hospitalized patients （aged from 42 to 68 years） who underwent endoscopic sinus surgery between 2003 and 2008. Twelve patients had inverted papilloma （IP）, two had nasal polyps, two had Kubo＇s postoperative cyst of MS, one had recurrent bone cyst of maxilla, one had dentigerous cyst and one had bleeding of internal maxillary artery secondary to CaldwelI-Luc operation respectively. Two IP patients were excluded from this group since the follow-up time was less than 12 months. The NLD was dissected after removing the anterior bony portion of nasal lateral wall. The prelacrimal recess approach （PLRA） to MS was established when IT-NLD flap was raised medially. The flap was repositioned when MS lesion was removed. Results All the 17 patients had unilateral lesions. Ten MS IP patients were at the T3 Krouse stage. The follow-up ranged from 7 to 60 months. No recurrence was seen in 16 patients. Only one IP patient had a local recurrence in MS. All of them had no any complications. Conclusion The diffuse or severe diseases of MS may be the potential indications for PLRA.
文摘目的比较不同鼻内镜下手术方法治疗变应性鼻炎(AR)伴鼻中隔偏曲的效果。方法将2014年12月至2017年1月间中山市小榄人民医院诊治的100例AR伴鼻中隔偏曲患者根据随机数表法分为观察组和对照组各50例,观察组行鼻内镜下鼻中隔黏膜下切除术联合下鼻甲黏膜下海绵体部分切除术,对照组行常规鼻内镜下鼻中隔黏膜下切除术,比较两组患者术后1个月的疗效及并发症发生情况。结果观察组和对照组患者术后症状积分[(1.32±0.36)分vs(1.61±0.39)分]和体征积分[(1.24±0.27)分vs (1.87±0.43)分]比较,观察组均明显低于对照组,差异均有统计学意义(P<0.05);观察组和对照组患者术后糖精清除率[(16.32±2.16) min vs (17.61±2.25) min]、鼻腔阻力[(0.30±0.09) kPa/(L·s) vs (0.47±0.11) k Pa/(L·s)]比较,观察组均明显低于对照组,差异有统计学意义(P<0.05);观察组患者的治疗总有效率为94.0%,明显高于对照组的84.0%,差异具有统计学意义(P<0.05);观察组患者术后并发症发生率为2.0%,略低于对照组的10.0%,但差异无统计学意义(P>0.05)。结论鼻内镜下鼻中隔黏膜下切除术联合下鼻甲黏膜下海绵体部分切除术治疗AR伴鼻中隔偏曲可显著改善患者临床症状,效果优于单独鼻中隔黏膜下切除术。
