摘要
目的探讨修正性鼻内镜手术的解剖标志,减少手术中的风险,更有效地治疗复发性慢性鼻窦炎、鼻息肉Ⅲ型。方法对98例(156侧)复发性慢性鼻窦炎、鼻息肉Ⅲ型患者行修正性手术,术中寻找较恒定的解剖标志为后鼻孔、上颌窦口、中鼻甲(或残余)、蝶窦前壁及眶纸板,并根据术前CT指引寻找鼻丘气房、上鼻甲及中鼻甲基板(或残余),在相关的解剖标志的指引下行全筛窦切除、蝶窦开放(如必要)、上颌窦及额窦开放,并记录上述解剖标志的出现率。结果手术无严重并发症,术中皆可找到较恒定的解剖标志,鼻丘气房、上鼻甲及中鼻甲出现率较高,治愈75例,好转20例,无效3例。结论运用较恒定的后鼻孔、上颌窦口、中鼻甲(残余)、蝶窦前壁和眶纸板以及鼻丘气房、上鼻甲及中鼻甲基板指引,能安全、有效地完成修正性鼻内镜手术,防止严重并发症发生,有效治疗复发性慢性鼻窦炎、鼻息肉Ⅲ型。
Objective To explore the surgical anatomic landmarks of revisional endoscopic surgery of nasal cavity so as to reduce the risk of surgery and obtain more effective treatment of recurrent chronic sinusitis and nasal polyps type III. Methods During the revisional surgeries of 98 cases（156 sides） of recurrent chronic sinusitis and nasal polyps type III ,we searched a number of comparatively constant anatomical landmarks： posterior nares,apertura maxillaris,middle tnrbinate （or residues）,antetheca of sphenoid sinus and orbital board,as well as nasoturbinal concha cell air,superior turbinate and middle turbinate basalia （or residues） according to preoperative CT guidance. Based on the anatomical landmark,we performed whole ethmoidectomy,sphenoid sinus patefaction （if necessary）,maxillary sinus and the frontal sinus patefaction. Meanwhile we recorded of the occurrence of the above-mentioned anatomical landmarks. Results We could found comparatively constant anatomical landmarks during the surgeries without serious complications. Nasoturbinal eoncha cell air,superior turbinate and middle turbinate appeared more frequently. 75 cases were cured,20 cases were improved and 3 cases were ineffective. Conclusion The use of posterior nares,apertura maxillaris, middle turbinate（or residues）,antetheca of sphenoid sinus and orbital board,as well as nasoturbinal concha cell air,superior turbinate and middle turbinate basalia（or residues） as surgical guid- ance contributed to perform the revisional endoscopic surgery of nasal cavity safely and effectively without serious complications. Recurrent chronic sinusitis and nasal polyps type III could be treated effectively.
出处
《中国现代医生》
2010年第35期122-123,共2页
China Modern Doctor
