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关于上颌窦手术时下鼻道是否需造对孔问题,曾在日本第十七次鼻窦炎学会(1978)和第十次鼻窦临床问题讨论会(1980)上进行了热烈讨论,与会者对对孔这一近百年来几乎已成为常规的操作步骤各抒己见,提出争议。尽管并无定论,但通观各种论点,便可对其趋势有一大致了解。【历史】在上颌窦炎治疗发展史上,最初是经上颌窦自然孔冲洗和经下鼻道穿刺或开窗排脓,此后为了获得持久效果才开展了手术疗法;几经变迁,才由美国Caldwell(1893)和法国Luc(1897)完成了今日的经典的上颌窦根治术。由于当时尚无磺胺和抗生素,故上颌窦积脓即有招致危及生命的眶内和颅内合并症的危险,所以手术目的自然以引流为主,手术原则主要为去除病灶,下鼻道造对孔以保证引流通畅。而和辻-
On the maxillary sinus surgery when the need to make holes on the issue of the nose, the Japanese 17th Society of Sinusitis (1978) and the 10th Symposium on sinus clinical issues (1980) on the heated discussion, participants on the hole This nearly a hundred years has become almost routine steps to express their views and controversy. Although there is no conclusion, we can get a general idea of the trend through various arguments. History In the history of the treatment of maxillary sinusitis, initially through the natural maxillary hole flushing and the inferior nasal puncture or fenestration, then in order to obtain long-lasting effect was carried out before surgery; only after several changes, by the United States Caldwell ( 1893) and France Luc (1897) completed today’s classic maxillary sinus surgery. Because there was no sulfa and antibiotics, so the maxillary sinus emphysema that has endanger life-threatening orbital and intracranial complications, so the purpose of the operation to drain the main purpose of surgery is mainly to remove the lesion, the inferior nasal hole To ensure smooth drainage. And 辻 -