论文部分内容阅读
目的 :探讨修正性内窥镜鼻窦手术治疗复发性鼻窦炎、鼻息肉的临床意义。方法 :采用内窥镜鼻窦手术对 112例复发性鼻窦炎、鼻息肉患者进行了修正性治疗 ,术中采用 Messerklinger技术、Stryker切削器 ,并辅以控制性降压。结果 :病变清除满意 89例 (79.5 % ) ,手术欠满意 17例 (15 .2 % ) ,6例失败。并发脑脊液鼻漏 1例、眼眶血肿 4例、术后溢泪 3例 ,大出血 12例。结论 :修正性手术适用于鼻窦内窥镜手术后出现的术腔随访清理难以控制的鼻窦炎病变。但该术对于堵塞、粘连性病变效果较好 ,鼻息肉病效果欠佳。中鼻甲残根和后鼻孔上穹窿为手术重要的安全标志 ,术前 CT扫描可以减少并发症的发生。
Objective: To investigate the clinical significance of modified endoscopic sinus surgery in the treatment of recurrent sinusitis and nasal polyps. Methods: One hundred and twelve patients with recurrent sinusitis and nasal polyps were treated by endoscopic sinus surgery. Messerklinger technique, Stryker cutter and controlled hypotension were used. Results: 89 cases (79.5%) were satisfactorily satisfied with the lesion, 17 cases (15.2%) were unsatisfied with the operation, and 6 cases failed. Complication of cerebrospinal fluid rhinorrhea in 1 case, orbital hematoma in 4 cases, 3 cases of postoperative effusion, bleeding in 12 cases. Conclusion: Modified surgery is suitable for surgical follow-up of sinus surgery to clear up uncontrollable sinusitis. However, the surgery for blockage, adhesions lesions better, nasal polyposis ineffective. The middle turbinate remnant and posterior nares on the fornix are important safety signs of surgery. Preoperative CT scan can reduce the incidence of complications.