鼻腔结构异常的修正性鼻内镜手术  

Revision Functional Endoscopic Sinus Surgery for Nasal Cavity Abnormality

作　　者：马季青[1] 马嵩[1] 谢为民[1] 

机构地区：[1]河南省人民医院耳鼻喉科,郑州市450003

出　　处：《医药论坛杂志》2007年第9期12-13,16,共3页Journal of Medical Forum

摘　　要：目的探讨各种鼻腔结构异常修正性鼻内镜手术的选择及其疗效观察。方法回顾性分析2000年3月-2005年3月38例行修正性鼻内镜手术的原因,针对鼻腔不同的结构异常,采取相应的修正性鼻内镜手术。结果修正性鼻内镜手术原因:38例(58侧)中筛窦炎(包括筛窦骨质增生)24例(36侧),伴鼻息肉复发16例(32侧),中鼻甲外移致中鼻道狭窄13例(15侧),伴中鼻甲粘连11例(12侧),伴鼻中隔偏曲10例,额隐窝狭窄5例(7侧),蝶窦炎5例(6侧),上颌窦口闭锁5例(5侧),下鼻甲肥大3例(3侧)。38例中24例(63.16%)伴鼻腔结构异常,即中鼻甲、下鼻甲、鼻中隔及钩突相关病变。修正性鼻内镜手术后,随访6-43个月,痊愈22例,好转12例,无效4例。结论鼻内镜术后复发者多伴有鼻腔结构异常,鼻窦开放的同时矫正鼻腔各结构异常可提高手术疗效,降低复发率。Objective To discuss the operative plan for nasal cavity abnormality and evaluate the effect of revision FESS. Methods A retrospective study of 38 revision FESS performed during 2000.3- 2005.3 （age from 17 to 55 years old）is presented. Patients were evaluated with endoscopic examination of the nasal cavities and cormputed tomography of the sinuses and nasal cavities. Information was also collected during the revision surgery. The plan was designed according to nasal cavity abnormality. Results The reasons of revision FESS：Among 38 cases （58 sides）there are 24 ethmoid sinusitis（36 sides）, 16 cases（32 sides） with recurrence of polyps,13 middle meatal stenosis（ 15 sides）, 11 middle turbinate adhesion（ 12 sides）, 10 septal deviation ,5 frontal recess stenosis（7 sides） ,5 sphenoid sinusitis （6 sides）, 5 maxillary ostium obstruction （ 5 sides ）, 3 inferior turbinate hypertrophy （ 3 sides）. Follow up for 6 months- 43 months after revision FESS ,22 cases were successful, 12 satisfied and 4 inefficacy. Conclusion The primary FESS failure was associated with nasal cavity structure diseases. Meticulous attention in these areas and correcting it during surgery may reduce recurrence and ensure operative effect after revision FESS.

关 键 词：内窥镜检查 复发 再手术 

分 类 号：R765.041[医药卫生—耳鼻咽喉科]