文档介绍：慢性额窦炎鼻内镜下额窦开放100例分析
(作者:___________单位: ___________邮编: ___________)
【摘要】目的通过探讨慢性鼻窦炎鼻内镜手术中额窦开放的策略及技巧,以提高慢性鼻窦炎手术中额窦开放的成功率。方法经鼻内镜手术治疗慢性鼻窦炎100例(182侧),根据额窦口和额隐窝的不同病变和解剖特征,采用不同的手术方式处理局部病变。结果术中可见所有病例均有不同程度的中鼻道阻塞。额窦口和额隐窝情况分3种:①局部没有气房阻塞,仅为肿胀息肉样变黏膜或息肉阻塞者56侧(%);②额隐窝被发育过度的鼻丘气房、前筛气房或终末气房挤压导致引流通道狭窄者121侧(%);③额窦口骨性狭窄者5侧(%)。随访6~24个月,其中治愈171侧(94%),好转8侧(%),无效3侧(%)。并发症:所有病例术后均无眶、颅内并发症,15侧出现局部术腔粘连,经鼻内镜下换药后均治愈。结论额隐窝的阻塞和病变是慢性额窦炎的主要原因,通过术前CT检查确定不同的病变范围及特点,选择不同的手术方式及术中注意对额窦口周的粘膜保护,可以达到提高额窦开放的成功率及术后效果的目的。
【关键词】鼻内镜;额窦;CT;手术方式
【Abstract】 Objective To advance the clinical therapeutic efficacy by explore the tactic and skill of the access to the chronic frontal Different methods were used to manage different local diseases in frontal sinus orifice or frontal recess in 100 cases (182 sides) with chronic frontal sinusitis by nasal endoscopic Different degree of middle meatal obstruction was seen in all cases at situation of frontal sinus ostium and frontal recess was as follows:56 sides obstructed by swollen mucosa,polypoid mucosa or polyps,no cell obstruction at frontal sinus orifice;121 cases constricted by over development of agger nasi cells,ethmoid bulla or terminal cell at frontal recess;osteal stenosis at frontal sinus orifice in 5 sides. Follow up for 6~24 months showed that 171 sides(94%)were cured,8 sides(%)better and 3