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目的通过报告6例改良经鼻内镜下Lothrop手术经验,探讨相关技术方法的应用及手术适应证的选择。方法6例额窦病变患者,年龄6～63岁;男4例,女2例。4例中额窦骨瘤1例,额窦复发性血管瘤1例,外伤性额窦黏液囊肿2例,术后复发性额窦黏液囊肿1例,额筛窦复发性内翻性乳头状瘤1例。采用经鼻内镜下额窦底切除额窦开放引流手术(modifiedendoscopicLothropprocedure,MELP)。其中2例术中在影像导航系统引导下定位和开放额窦底。结果6例均手术成功,术中和术后均未出现并发症,平均手术时间3.2h。随访6～40个月,鼻内镜检查额窦底额窦口融合开放良好,上皮化。患者术前症状消失,无复发。结论在严格适应证、合适器械及良好鼻内镜外科技术和经验的基础上,改良经鼻Lothrop手术是复杂额窦病变治疗方式的理想选择。
Objective Through the report of 6 cases of modified endoscopic Lothrop surgery experience to explore the application of relevant technical methods and the choice of surgical indications. Methods Six cases of frontal sinus lesions, aged 6 to 63 years; 4 males and 2 females. 4 cases of frontal sinus tumor in 1 case, frontal sinus recurrent hemangioma in 1 case, traumatic frontal sinus mucosa in 2 cases, recurrent frontal sinus mucosa in 1 case, frontal ethmoid sinus recurrent inverted papilloma 1 case. Transnasal endoscopic sinus resection of frontal sinus open drainage (modifiedendoscopic Lothropprocedure, MELP). Two of them were located and open the frontal sinus floor under the guidance of video navigation system. Results All the 6 cases were successful in operation. No complications occurred during or after operation. The average operation time was 3.2 hours. Followed up for 6 to 40 months, nasal endoscopic frontal sinus frontal orifice fusion open well, epithelialization. Preoperative symptoms disappeared, no recurrence. Conclusion Based on strict indications, appropriate instruments, and good endoscopic surgical techniques and experience, modified nasal Lothrop surgery is an ideal choice for the treatment of complex frontal sinus lesions.