[Objective] To observe the anatomic characteristics of frontal recess (FR) and investigate the best approach of endoscopic frontal sinus surgery.[Methods] 39 cases (64 sides) were examined endoscopically and computed tomography in coronal and axial views,some of images were reconstructed in a parasagittal view.The approach of endoscopic frontal sinus surgery either an uncinate or an agger nasi approach was chosen according to examination results.[Results] A 6～16 month follow-up showed that 21 sides (77.8％) were cured,4 sides (14.8％)were improved,and 2 sides (7.4％) were recurrent in the uncinate approach group; and 29 sides (78.4％) were cured,5 sides (13.5％) were improved,and 3 sides (8.1％) were recurrent in the agger nasi approach group.No significant differences were found in the surgical outcomes between the two different surgical approaches.[Conclusion] The anatomy in frontal recess is complicated.The operation approach of choice is based on the results of computed tomographic scan and endoscopic examinations.The present study revealed that both surgical approaches could obtain similar outcomes.Thus,either approach or a combined approach can be chosen according to the actual situation in order to meet the satisfaction of the operations.%目的 观察额隐窝区域临床解剖特点,探讨鼻内镜下最佳额窦手术路径.方法 对39例(64侧)患者术前进行鼻内镜检查和CT冠状位、水平位扫描,矢状位重建.根据检查结果选择手术径路:钩突路径或鼻丘路径,行内镜下额窦开放术.结果 钩突路径治愈21侧(77.8％),好转4侧(14.8％),复发2侧(7.4％)；鼻丘路径治愈29侧(78.4％),好转5侧(13.5％),复发3侧(8.1％).两种路径手术方式在治疗效果上比较差异无显著性(P＞0.05).结论 额隐窝区解剖复杂.CT和鼻内镜检查结果是选择不同手术路径的重要依据.钩突路径或鼻丘路径具有等同的治疗效果.术中可根据情况选定一种路径或采用两种路径结合的方法.
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