鼻内镜手术治疗后鼻孔息肉  

Endoscopic sinus surgery for choanal polyps

作　　者：于沿凯[1] 孟粹达[2] 肖北春[1] 

机构地区：[1]吉林省人民医院耳鼻咽喉科,吉林长春130012 [2]吉林大学中日联谊医院耳鼻咽喉头颈外科,吉林长春130033

出　　处：《中国耳鼻咽喉头颈外科》2008年第12期682-684,共3页Chinese Archives of Otolaryngology-Head and Neck Surgery

摘　　要：目的探讨后鼻孔息肉的起源部位,分析鼻内镜下治疗后鼻孔息肉的疗效。方法回顾性分析1999～2006年间行鼻内镜手术的63例后鼻孔息肉患者的临床资料。结果59例上颌窦后鼻孔息肉,42例可在上颌窦内确切定位起源部位,其中起源于内上壁16例,后壁为9例,前壁为3例,下壁为3例,外侧壁为2例,上壁2例,前内壁为4例,前外侧壁1例,后上壁1例,外下壁1例;2例起源于鼻中隔;1例起源于蝶窦;1例起源于前组筛窦。所有病例均在鼻内镜下手术切除。术后随访6～30个月,4例复发,经二次手术治愈。5例并发鼻腔粘连,经松解后解除粘连。结论后鼻孔息肉多原发于上颌窦内侧壁。采用鼻内镜手术治疗安全、有效。术前明确后鼻孔息肉的起源部位对手术方式的选择至关重要。OBJECTIVE To explore the site of origin of choanal polyps （CP） and to analyze the outcome of endoscopic sinus surgery （ESS） in patients with CP. METHODS The clinical data of 63 cases with CP underwent ESS from 1999 to 2006 were studied retrospectively. RESULTS In 59 cases with antrochoanal polyps, 42 cases could be located the site of origin within the maxillary sinus exactly. The antrochoanal polyps originated from interior superior wall in 16 cases, posterior wall in 9 cases, anterior wall in 3 cases, inferior wall in 3 cases, lateral wall in 2 cases, superior wall in 2 cases, anterointernal wall in 4 cases, anterolateral wall in 1 cases, posterior superior wall in 1 cases, and lateral inferior wall in 1 case. There were 2, 1 and 1cases originated in the nasal septum, sphenoid sinus and anterior ethmoid sinus respectively. During follow up for 6 to 30 months, 4 cases were recurred,who were cured undergoing a second operation. Five cases had the complication of nasal adhesion, which was removed by excision. CONCLUSION The majority of CP are originated from interior wall of the maxillary sinus. ESS is safe and effective in the treatment of CP. Located the site of origin preoperatively is necessary to choose the mode of operation.

关 键 词：鼻息肉 内窥镜检查 上颌窦 后鼻孔息肉 

分 类 号：R765.9[医药卫生—耳鼻咽喉科]