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目的总结鼻内镜下采用鼻丘径路开放额窦的疗效,并与以钩突为主要参考标志的鼻内镜下额窦开放术的疗效进行比较,探讨鼻丘在鼻内镜下额窦开放术中的作用。方法47例(85侧)患者接受鼻内镜下额窦开放术,其中鼻内镜下鼻丘径路额窦开放术26例(49侧),开放鼻丘前壁,经鼻丘后内上方开放额窦。以钩突为主要参考标志的鼻内镜下额窦开放术21例(36侧),通过判定钩突上端与鼻腔外侧壁附着点的位置开放额窦。结果①两组患者均平均随访9个月(6～12个月),术后所有患者主观症状均有不同程度的缓解,鼻内镜下评价两组患者的治愈率分别为84%和81%,差异无统计学意义(χ2=0.139,P>0.05);②近半数鼻丘径路手术可在0°鼻内镜下完成(46%),使用30°或70°鼻内镜相对较少;而钩突标志组手术全部需要使用30°鼻内镜,多数病例(71%)需要70°鼻内镜。结论鼻丘和钩突同为鼻内镜下额窦开放术的重要参考标志,根据患者病情正确选择手术方式,可获得满意疗效。
Objective To summarize the curative effect of open frontal sinus treated by nasal endoscopy with nasal endoscopy and to compare the curative effect of nasal endoscopic sinus surgery with rhizotomy as the main reference mark. Intraoperative role. Methods Forty-seven patients (85 sides) underwent nasal endoscopic sinus surgery. Among them, 26 cases (49 sides) of nasal frontal sinus were opened by nasal endoscopy, and the anterior wall of the nasal cavity was opened. Frontal sinus. 21 cases (36 sides) of nasal frontal sinus open surgery with rhizotomy as the main reference mark, the frontal sinus was opened by determining the position of the upper hook and the outer wall of the nasal cavity. Results ①All patients were followed up for an average of 9 months (range, 6-12 months). All subjective symptoms were relieved to varying degrees after operation. The cure rates of the two groups were 84% and 81%, respectively, (Χ2 = 0.139, P> 0.05). ② Nearly half of the nasal pathways were completed under 0 ° endoscopic surgery (46%), while 30 ° or 70 ° endoscopic sinus surgery was relatively less. The hook sign group surgery required the use of 30 ° endoscopic endoscopy, most cases (71%) need 70 ° endoscopic. Conclusions Nose and uncinate process are important reference signs for the opening of the frontal sinus during endoscopic sinus surgery. Satisfactory curative effect can be obtained according to the correct choice of operation method according to the patient’s condition.