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目的评价经鼻内镜鼻腔外侧壁切开联合中鼻道入路在上颌窦区手术中的临床应用价值。方法对2例上颌窦内翻性乳头状瘤,1例非侵袭性真菌性上颌窦炎患者行经鼻内镜鼻腔外侧壁切开联合中鼻道入路在上颌窦区手术清除病变组织,术中对该手术径路在内镜下能获得的手术视野进行观察,对该手术的优点进行评价。结果 3例患者均成功施行手术并随访6个月以上获得满意疗效,通过该径路可获得内镜下上颌窦各壁的暴露,对彻底清除病变有良好的视野。结论经鼻内镜鼻腔外侧壁切开联合中鼻道入路在上颌窦区手术具有微创,能多角度观察病变区域,更彻底清除病变等优点;缺点是手术操作相对复杂,损伤鼻泪管膜部可能性大,需丰富的解剖知识及熟练的内镜操作技巧。
Objective To evaluate the clinical value of transnasal endoscopic nasal lateral wall incision combined with middle nasal approach in maxillary sinus surgery. Methods Two cases of maxillary sinus inverted papilloma and one case of non-invasive fungal maxillary sinusitis underwent nasal endoscopic nasal lateral wall dissection combined with middle-nasal approach to remove the diseased tissue in the maxillary sinus region. The operative path of the surgical approach was obtained under endoscopy to observe the advantages of the surgery. Results All the 3 patients were successfully operated and were followed up for more than 6 months to obtain satisfactory curative effect. Through this approach, the exposure of each wall of maxillary sinus under endoscopy can be obtained, and a good visual field can be obtained for the complete removal of the lesion. Conclusion Nasal endoscopic nasal lateral wall incision combined with the middle nasal approach in the maxillary sinus surgery with minimally invasive, multi-angle lesions can be observed, more thorough removal of lesions and other advantages; disadvantage is that the operation is relatively complicated, damage the nasolacrimal duct Membrane Department is likely to be rich in anatomical knowledge and skilled endoscopic operating skills.