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目的探讨影像导航系统在鼻内镜下蝶窦病变手术的应用及优势。方法我们应用影像导航系统结合鼻内镜对37例蝶窦病变行手术,其中单纯蝶窦炎21例,干酪性蝶窦炎6例,蝶窦囊肿10例(其中黏液囊肿6例,黏膜囊肿4例)。患者均采用气管插管全麻,全麻后通过导航定位注册成功,根据手术中的需要标定探针或吸引器作为术中的定位设备,在鼻内镜下,通过使用导航定位设备以判断术中器械到达的具体位置、了解局部解剖关系,确定蝶窦位置,开放蝶窦,清除病变;针对蝶窦囊肿,则仅切除囊肿前壁或前下壁,凿孔孔径约1cm×0.5cm,勿需清除所有囊壁;蝶窦黏膜囊肿则需将囊肿完全清除。结果37例手术均取得了成功,无术中、术后并发症发生。结论影像导航系统结合鼻内镜治疗蝶窦病变可以有效地提高手术疗效和避免并发症的发生。
Objective To explore the application and advantages of video navigation system in the treatment of sphenoid sinus diseases under endoscopic sinus surgery. Methods 37 cases of sphenoid sinus diseases were treated by video navigation system and endoscopic sinus surgery. Among them, 21 cases were simple sphenoid sinusitis, 6 cases were caused by caseous sphenoid sinusitis, 10 cases were sphenoid cysts (including 6 cases of mucous cyst, 4 cases of mucosal cyst example). Patients were tracheal intubation general anesthesia, navigation and registration through the successful registration, according to the need to calibrate the needle or aspirator during surgery as a positioning device within the endoscopic, through the use of navigation and positioning equipment to determine the operation In the specific location of the arrival of the instrument to understand the local anatomical relationship to determine the sphenoid sinus position, open the sphenoid sinus, clear the lesion; for sphenoid sinus cysts, only the anterior cyst or the anterior wall, the perforated aperture of about 1cm × 0.5cm, do not Need to clear all of the wall; sphenoid mucosal cyst is required to completely remove the cyst. Results All the 37 cases were successful. No intraoperative or postoperative complications occurred. Conclusion Video navigation system combined with endoscopic treatment of sphenoid sinus disease can effectively improve the surgical efficacy and avoid the occurrence of complications.