低温等离子消融并全降解鼻窦药物支架系统行先天性双侧后鼻孔闭锁成形术1例  

Treatment of congenital bilateral choanal atresia by low temperature plasma ablation and fully degradable sinus drug stent:a case report

作　　者：丁赞[1] 杨柳[1] 刘玉欣[1] 崔鑫[1] 李达[1] 董金叶[1] DING Zan;YANG Liu;LIU Yuxin;CUI Xin;LI Da;DONG Jinye(Department of Otolaryngology Head and Neck Surgery,Women and Children's Hospital Affiliated to Qingdao University,Qingdao,266034,China)

机构地区：[1]青岛大学附属妇女儿童医院耳鼻喉科,山东青岛266034

出　　处：《临床耳鼻咽喉头颈外科杂志》2024年第9期879-882,共4页Journal of Clinical Otorhinolaryngology Head And Neck Surgery

摘　　要：探讨低温等离子消融术配合全降解鼻窦药物支架系统在膜性闭锁为主的先天性后鼻孔闭锁治疗中的应用。分析2023年4月收治的1例膜性双侧后鼻孔闭锁患儿,采用鼻内镜下低温等离子射频消融术的手术方式切除闭锁板,术后放置全降解鼻窦药物支架。患儿术后鼻通气明显改善,后鼻孔成形良好,未见手术并发症,随访8个月,成形的后鼻孔未见再狭窄或闭锁,术中放置的药物支架已完全降解消失。低温等离子消融术治疗膜性闭锁为主的先天性后鼻孔闭锁具有减少手术创伤、保护正常组织结构、避免手术并发症的优势,同时合并全降解鼻窦药物支架的应用,可减轻术区黏膜水肿,减少肉芽组织增生,加快术后创面黏膜化,从而有效降低鼻腔粘连、后鼻孔再狭窄,甚至闭锁的发生率,可获得较为满意的疗效。To investigate the application of low temperature plasma ablation combined with fullly degradable sinus stent system in the treatment of congenital choanal atresia mainly menbranous atresia.A child with membranous bilateral choanal atresia admitted in April 2023 was analyzed.This case underwent endoscopic ablative posterior nostriplasty and placed a fully degradable drug stent in bilateral operative cavities.The case's nasal ventilation was effectively improved after operation and the profile of postnaris was well formed.No restenosis oratresia was found under electronic nasopharyngoscope and the drug stent was completely degraded after 8 months follow-up.Low temperature plasma ablation has the advantages of reducing surgical trauma,protecting normal tissue and avoiding complications in the treatment of congenital choanal atresia.At the same time,combined with the application of the fully degradable sinus drug stent,it can achieve remarkable efficacy by alleviating mucosal edema,reducing granulation tissue hyperplasia,accelerating wound mucosification,and effectively reducing the incidence of nasal adhesion,restenosis or even atresia.

关 键 词：儿童 先天性后鼻孔闭锁 膜性 射频消融术 全降解鼻窦药物支架 

分 类 号：R765.7[医药卫生—耳鼻咽喉科]