103例修正性额窦炎手术对额隐窝阻塞 的观察及分析报道

Observation and analysis of frontal recess obstruction in 103 cases of revision surgery for recurrent frontal sinusitis

摘要:

目的 探讨鼻内镜下额窦炎手术后复发原因。方法 2009年1月～2012年6月对74名（103例/侧）复发性额窦炎患者行修正性鼻内镜手术，术中探查额隐窝阻塞因素，分析额窦炎症状再发原因。结果 共探查103例（侧）额隐窝，发现阻塞原因有以下5种：黏膜病变（67%）；残留气房（64％）；中鼻甲外移（30%）；纤维瘢痕增生（14%）；骨质增生（7%）。常为多种病因共存于同一额隐窝中。结论 复发性额窦炎可由多种额隐窝阻塞性因素引起，需施行修正性鼻内镜手术。选择适当的手术方式有利于畅通额隐窝引流，避免手术失败。

Abstract:

【Objective】 To explore the reason of recurrent frontal sinuitis after endoscopic surgery. 【Methods】 74 patients who suffered from recurrent frontal sinuitis received reoperation under endoscope from2009 to 2012. 【Results】 103 frontal recesses were explored in reoperation and blockage of frontal recess was following five reasons: mucosal disease (67%); residul cells (64％); middle turbinate shift (30%); fiber hyperplasia(14%); hyperostosis (7%). Multi-factors were found frequently in one case. 【Conclusion】 Failure in frontal surgery can be due to blockage of frontal recess by multiple agents. Complete drainage of frontal recess through proper method could avoid failure.