基于演化发育生物学理论对鼻息肉的认识来探讨CRSwNP手术的演进  

Explore the progress of CRSwNP surgery based on the theory of evolutionary developmental biology

作　　者：刘锦峰[1] 王宁宇[1] 

机构地区：[1]首都医科大学附属北京朝阳医院,北京朝阳100020

出　　处：《中国医学文摘（耳鼻咽喉科学）》2020年第1期46-49,I0003,共5页Chinese Medical Digest(Otorhinolaryngology)

摘　　要：演化发育生物学关于鼻的形成理论认为,人类和哺乳动物的鼻是由嗅觉鼻、呼吸鼻及鼻窦三部分的进化与组合而成。而筛窦不是鼻窦,是前颅底骨,属于嗅觉鼻。嗅觉黏膜是嗅板内陷所形成的结构。鼻息肉为筛骨非嗅觉黏膜(退化的筛骨嗅黏膜)的慢性炎症性疾病。基于演化发育生物学理论对鼻息肉的认识,鼻息肉起源于筛骨,那么治愈的策略将与筛骨切除的多少有关。上述观点支持尽可能的筛骨切除的轮廓化鼻窦手术,也支持在轮廓化鼻窦手术基础上的完全或部分切除鼻窦黏膜。According to the evo-devo concept,the nose of humans and mammals is formed by the evolution and combination of olfactory nose,respiratory nose and sinuses.Ethmoid is not seen as a sinus,it can be considered as the skull-base bone containing the sensory mucosa of the olfactory nose.The nasal polyposis is a chronic inflammatory disease of the vestigial ethmoidal olfactory mucosa.Then the surgical strategy will be related to how much the ethmoid bone is removed,based on understanding of nasal polyps and evo-devo concept.The above views support the procedure of radical sinus surgery(RSS)which was the excision of the ethmoid bone as much as possible,and also support complete or partial removal of the paranasal mucosa on the basis of RSS.

关 键 词：鼻窦(Paranasal sinus) 演化发育生物学(The evo-devo) 慢性鼻窦炎(Chronic rhinosinusitis) 鼻息肉(Nasal polyps) 鼻内镜鼻窦手术(Endoscopic SINUS surgery) 

分 类 号：R76[医药卫生—耳鼻咽喉科]