鼻内镜下Draf Ⅱ-Ⅲ型额窦开放手术在颅脑外伤术后反复额窦感染并窦道形成中的应用  

Application of nasal endoscopic Draf Ⅱ-Ⅲ frontal sinus surgery in recurrent frontal sinus infection and sinus formation after craniocerebral trauma

作　　者：吕操[1] 黄晓斌[2] 陈杰 兰忠[1] 涂艺 杨晓红[1] 白忠[1] LYU Cao;HUANG Xiaobin;CHEN Jie;LAN Zhong;TU Yi;YANG Xiaohong;BAI Zhong(Department of Otolaryngology,the Second Affiliated Hospital,Kunming Medical University,Kunming,Yunnan,650101,China;Department of Neurosurgery,the Second Affiliated Hospital,Kunming Medical University,Kunming,Yunnan,650101,China)

机构地区：[1]昆明医科大学第二附属医院耳鼻咽喉科,云南昆明650101 [2]昆明医科大学第二附属医院神经外科,云南昆明650101

出　　处：《中国耳鼻咽喉头颈外科》2024年第4期248-250,共3页Chinese Archives of Otolaryngology-Head and Neck Surgery

摘　　要：目的探讨鼻内镜下DrafⅡ-Ⅲ型额窦开放手术在颅脑外伤术后反复额窦感染并窦道形成中的应用。方法8例颅脑外伤术后反复额窦感染的患者,主要表现为头痛、额部反复感染、流脓、窦道形成,发病时间平均43.25个月。患者在鼻内镜下行DrafⅡ-Ⅲ型额窦开放术,其中DrafⅡa型2例,DrafⅡb型5例,DrafⅢ型1例,术中扩大开放额窦口,见额窦内有骨蜡堵塞额窦口,取出骨蜡,额窦引流通畅。全部患者未做面部切口。结果术后8例患者额部感染明显减轻,治愈出院,术中、术后未发生脑脊液鼻漏或颅内感染。出院后,于1、3、6、12个月进行门诊随访复查,见额窦口保持通畅,额部未再发生感染,瘘口逐渐愈合。结论鼻内镜下采用DrafⅡ-Ⅲ型额窦开放术式,是处理颅脑外伤术后额窦反复感染并窦道形成的有效手术方式。OBJECTIVE To investigate the application of endoscopic Draf Ⅱ-Ⅲ frontal sinus surgery in the treatment of recurrent frontal sinus infection and fistula formation after craniocerebral trauma.METHODS There were 8 cases of recurrent frontal sinus infection after craniocerebral trauma,the main manifestations were headache,recurrent frontal infection,discharge of pus,fistula formation.The average onset time was 43.25 months.The patients underwent DRAF Ⅱ-Ⅲ frontal sinus surgery under nasal endoscopy,including DrafⅡa 2,DrafⅡb 5,and DrafⅢ1,respectively.During the operation,the frontal sinus ostium was expanded.It was found that bone wax blocked the frontal sinus ostium in the frontal sinus.The bone wax was removed,and the frontal sinus drainage was smooth.No facial incision was made in all patients.RESULTS There were 8 patients with frontal infection who were cured after surgery.No cerebrospinal fluid rhinorrhea or intracranial infection occurred during or after operation.After discharge,the outpatient follow-up review was conducted in 1,3,6,and 12 months.It was found that the frontal sinus remained unobstructed.The frontal sinus did not become infected again,and the fistula gradually healed.CONCLUSION Draf II-III frontal sinus surgery under nasal endoscopy is an effective way to treat recurrent frontal sinus infection and fistula formation after craniocerebral trauma.

关 键 词：内窥镜检查 鼻窦炎 额窦 颅脑损伤 感染 

分 类 号：R765.9[医药卫生—耳鼻咽喉科]