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目的:探讨在鼻内镜手术中额窦口处理时的手术技巧。方法:211例(288侧)额窦病变患者,予以保留功能的额窦开放术。均在0°内窥镜下切除钩突,开放筛窦,并尽可能开放鼻丘气房,开放额隐窝。内窥镜寻找额窦开口,用额窦钳开放窦口,彻底清除窦口周围病变组织,同时保留窦口粘膜。术后定期随访。结果:术后一年,144例(189侧鼻窦)患者,窦口引流完全通畅,周边完全上皮化,通畅率68%;41例(67侧鼻窦)窦口通畅,周围轻度水肿伴少量分泌物,患者自主症状改善,改善率19%;26例(32侧)窦口周边黏膜水肿解剖结构不清,伴有脓涕或头痛,无效13%。结论:内镜下额窦开放术是治疗慢性额窦炎的有效方法,鼻丘径路手术,解决额窦口引流问题,术野清楚,0°镜下即可完成手术,效果良好,有助于恢复额窦正常功能。
Objective: To explore the surgical technique of frontal sinus ostium in endoscopic sinus surgery. Methods: 211 cases (288 sides) of the frontal sinus lesions were reserved for prefrontal sinus surgery. All under 0 ° endoscopic removal of uncinate process, open ethmoid sinus, nasogastric atrium as far as possible and open the amount of crypt. Endoscopy to find the frontal sinus openings, with the frontal sinus pliers open the ostium, complete removal of the lesion tissue around the ostium, while preserving the ostium mucosa. Regular follow-up after surgery. RESULTS: One year after operation, sinus drainage was completely smooth in 144 patients (189 lateral sinuses) with complete peripheral epithelialization and patency rate of 68%. In 41 cases (67 lateral sinus), ostium was smooth and mild edema was accompanied with a small amount of secretion Patients, patients with autonomic symptoms improved, the improvement rate of 19%; 26 cases (32 sides) sinus mucosal edema around the anatomical structure is unclear, with purulent nasal or headache, ineffective 13%. Conclusion: Open frontal sinus surgery is an effective method for the treatment of chronic frontal sinusitis, nasal pathology surgery to solve the problem of frontal ostia drainage, clear surgical field, 0 ° mirror to complete the operation, the effect is good, help Restore the normal function of the frontal sinus.