论文部分内容阅读
近年来,随着鼻显微手术的发展,功能性鼻窦内窥镜手术为鼻窦炎及鼻息肉治疗提供了一个有效手段。笔者自1997年1月至1998年3月,采用鼻窦内窥镜行功能性鼻窦手术43例,术后对42例进行了随访,疗效满意。现报告如下。 1 临床与方法 1.1 临床资料:43例(72侧)中,男19例,女24例;年龄13～65岁。双侧29例,单侧14例。上颌窦炎11例,上颌窦炎伴鼻息肉8例,筛窦炎伴鼻息肉14铡,上颌窦囊肿8例,中鼻甲息肉样变2例。 1.2 手术方法:术前常规副鼻窦冠状位CT检查确定诊断,了解钩突有无变异及其与上颌窦口的关系,对窦腔病变范围及筛窦发育情况有初步认识,再根据术中鼻窦内窥镜下探查情况,采取不同术式。 1.2.1 功能性筛窦手术:用直径4mm,30度及70度视角镜,各种角度的咬钳,在内窥镜下先切除钩突,扩大中鼻道,咬除筛泡,再向后上咬除前筛窦窦壁炎症及息肉;继而开放后筛窦,切除炎性病变的筛窦及息肉。 1.2.2 上颌窦内窥镜手术:在内窥镜下先切除钩突,对中鼻甲息肉样变病例,切除中鼻甲外侧面息肉样
In recent years, with the development of nasal microsurgery, functional endoscopic sinus surgery provides an effective means for the treatment of sinusitis and nasal polyps. The author from January 1997 to March 1998, using sinus endoscopic sinus surgery in 43 cases of functional operation after 42 cases were followed up with satisfactory results. The report is as follows. 1 Clinical and methods 1.1 Clinical data: 43 cases (72 sides), 19 males and 24 females; aged 13 to 65 years. Bilateral in 29 cases, unilateral in 14 cases. Maxillary sinusitis in 11 cases, maxillary sinusitis in 8 cases with nasal polyps, ethmoid sinus with nasal polyps in 14 cases, maxillary sinus cyst in 8 cases, and middle turbinate polyp in 2 cases. 1.2 Surgical methods: Preoperative routine paranasal sinus CT examination to determine the diagnosis, to understand the uncountable uncinate process and its relationship with the maxillary ostium, the scope of sinus disease and the development of ethmoid sinus have a preliminary understanding, and then according to intraoperative sinus Endoscopy to explore the situation, to take different surgical procedures. 1.2.1 functional ethmoid sinus surgery: diameter 4mm, 30 degrees and 70 degrees angle lens, bite pliers of various angles, the first under the endoscope to remove the uncinate process, expand the middle nasal passages, bite the screen bubble, and then to After bite in addition to pre-ethmoid sinus wall inflammation and polyps; and then open the ethmoid sinus, removal of inflammatory lesions of the ethmoid sinus and polyps. 1.2.2 maxillary sinus endoscopic surgery: first in the endoscopic removal of the uncinate process, middle turbinate polypoid change cases, resection of lateral turbinate polyps