经鼻内镜手术治疗孤立性额窦良性病变24例观察

摘要

Aim:To explore the diagnosis of isolated frontal sinus benign disorder and the effect of en-doscopic frontal sinus surgery.Methods:Twenty-four patients who met the inclusion and exclusion crite-ria underwent endoscopic frontal sinus surgery.The results of endoscopic examination and the headache improvement were used to evaluate the efficacy before and after the operation.Results:The follow-up time was 6 to 1 1 months,1 9 patients were cured(79.1%),4 patients had effective outcomes(1 6.7%), 1 patients had no symptom improved (4.2%),20 cases had well drainage of frontal sinus ostia (83.4%),2 patients obstructed by swollen mucosa (8.3%).2 patients obstructed by scar tissue (8.3%).Conclusion:The surgery for headache caused by isolated frontal sinus benign disorder tran-snasal endosecope was effective.Skilled in assessing CT and operative technique are essential,in addi-tion its important that appropriate instruments and place NasoPore soaked in budesonide suspension in frontal recess.%目的：探讨孤立性额窦良性病变的诊断及经鼻内镜额窦开放手术的疗效。方法：选择24例以头痛为主诉的孤立性额窦良性病变患者，根据病变程度在局麻或全麻下行不同类型的经鼻内镜额窦开放术，以术前、术后鼻内镜检查结果及头痛症状改善程度评价手术疗效。结果：术后随访时间6～11个月，24例患者中19例临床症状完全消失，4例头痛症状缓解，1例头痛症状无改善；鼻内镜观察20例患者额窦口开放良好，额隐窝粘膜上皮化，2例额隐窝粘膜水肿，药物治疗后头痛改善，2例额窦口闭锁患者经再次手术后头痛症状消失。所有患者术中、术后均未出现严重并发症。结论：经鼻内镜额窦开放术治疗孤立性额窦良性病变所致鼻源性头痛疗效确切。术前仔细分析冠状位CT，术中尽量减少额隐窝粘膜的损伤，术后额隐窝放置浸泡普米克令舒的纳吸棉及选择合适的手术器械是手术成功的关键。