Mendians A E, Marks S C
Department of Otolaryngology, Wayne State University School of Medicine, Detroit, Michigan 48235, USA.
Laryngoscope. 1999 Sep;109(9):1495-8. doi: 10.1097/00005537-199909000-00025.
To evaluate the indications, technique, and results after long-term follow-up of osteoplastic frontal sinusectomy with fat obliteration.
A retrospective review of a series of consecutive patients using objective and subjective outcome assessment.
A retrospective chart review was conducted of all patients undergoing osteoplastic flap procedure with obliteration between July 1, 1991, and July 1, 1997. Each patient also completed a symptom questionnaire rating the degree of symptoms both before and after surgery using a 10-point scale. The results were tabulated and analyzed for statistical significance.
Twenty osteoplastic flap procedures to obliterate the frontal sinus were reviewed. The average patient age was 41 years, with the average duration of follow-up being 40.2 months. No surgical failures were noted; one patient underwent a negative reexploration. One surgical and one medical complication are reported. Statistically significant improvement was noted in overall symptoms, headache, congestion, drainage, and frequency of infections when the preoperative to the postoperative symptom scores were compared (P < .001).
Based on these results, the use of the osteoplastic flap in the obliteration of the frontal sinus continues to be an option in the era of endoscopic treatment of frontal sinus disease, particularly in endoscopic failures and chronic frontal sinus pain.
评估采用脂肪填充的骨成形性额窦切除术的适应证、技术及长期随访结果。
采用客观和主观结果评估对一系列连续患者进行回顾性研究。
对1991年7月1日至1997年7月1日期间所有接受骨成形瓣手术并进行填充的患者进行回顾性病历审查。每位患者还完成了一份症状问卷,使用10分制对手术前后的症状程度进行评分。将结果制成表格并进行统计学意义分析。
回顾了20例采用骨成形瓣填充额窦的手术。患者平均年龄为41岁,平均随访时间为40.2个月。未发现手术失败情况;1例患者进行了阴性再次探查。报告了1例手术并发症和1例医疗并发症。比较术前和术后症状评分时,总体症状、头痛、鼻塞、流涕及感染频率均有统计学意义的改善(P < .001)。
基于这些结果,在额窦疾病的内镜治疗时代,骨成形瓣用于填充额窦仍是一种选择,尤其是在内镜治疗失败和慢性额窦疼痛的情况下。