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目的探讨鼻内镜下微创手术治疗鼻黏膜接触性头痛的有效方法。方法对27例确诊为鼻黏膜接触性头痛的患者,在鼻内镜下行中鼻甲成形、下鼻甲外移、钩突及筛窦部分切除和鼻中隔偏曲部位的局部矫正等微创手术。术中注意对患侧和病变轻微侧的对称性处理。术后随访2~8个月,平均6个月。结果 20例痊愈,6例显效,1例无效。总有效率96.3%。1例术中造成穿孔,取筛骨垂直板修补,术后换药5个月愈合,头痛症状亦缓解。结论鼻黏膜接触性头痛多由鼻腔、鼻窦的解剖异常引起,鼻内镜下对称性微创手术治疗效果良好。
Objective To explore the effective method of nasal endoscopic minimally invasive surgery for nasal mucosal contact headache. Methods Twenty-seven patients with nasal mucosal contact headache underwent endoscopic minimally invasive surgery such as middle turbinate formation, inferior turbinate outward, uncinate process and partial ethmoid sinus resection and local correction of nasal septum deviation. Intraoperative attention to the lesser side of the lesion and the symmetry of the treatment. Follow-up postoperatively 2 to 8 months, an average of 6 months. Results 20 cases recovered, 6 cases markedly effective, 1 case ineffective. The total efficiency of 96.3%. Perforation occurred in 1 case, vertical plate of ethmoid bone repair dressing after 5 months healing, headache symptoms are also alleviated. Conclusions Nasal mucosa contact headache is mostly caused by abnormal anatomy of the nasal cavity and paranasal sinuses. Symmetry minimally invasive surgery under endoscopic sinus surgery is effective.