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[采用双侧颞部冠状切口的额窦骨成形术及面部轮廓重建的功能和美学效果]

[Functional and esthetic results of osteoplastic frontal sinus operations and profile reconstruction with bitemporal coronal incision].

作者信息

Kausch I, Handrock M

机构信息

Klinik für HNO-Krankheiten, Plastische Kopf- und Halschirurgie, Klinikum Nord-Heidberg, Hamburg.

出版信息

HNO. 2000 Oct;48(10):735-42. doi: 10.1007/s001060050650.

Abstract

BACKGROUND AND OBJECTIVE

The majority of inflammatory frontal sinus diseases requiring operative intervention can now be managed successfully by endonasal surgery. In problematic cases, however, optimal exposure of the entire frontal sinus and possibly complete mucous membrane removal combined with sinus obliteration must be achieved. In these cases, external frontal sinus surgery is indicated.

PATIENTS/METHODS: The operative approach and findings of 35 osteoplastic sinusotomy operations and 5 forehead reconstruction operations with porous polyethylene are reviewed. Median follow-up was 3.7 years, ranging from 1 to 7 years. Indications for surgery were trauma (12), infections (8), tumors (11), muco- or pyoceles (4), and frontal deformities (5).

RESULTS

The overall functional and esthetic result was excellent. No recurrent infection was noted. None of the patients have required revision surgery so far, and no serious complications occurred. Abnormal forehead sensation was reported by 12 patients (30%). Temporary double vision was described in 3 cases (7.5%).

CONCLUSIONS

Due to optimal sinus exposure and advantageous incision, osteoplastic frontal sinusotomy leads to excellent functional and esthetic results. Porous polyethylene demonstrates superior material properties and seems to be, in comparison with other implants, the current material of choice in frontal reconstruction.

摘要

背景与目的

大多数需要手术干预的炎性额窦疾病现在可以通过鼻内手术成功治疗。然而,在一些疑难病例中,必须实现对整个额窦的最佳暴露,并可能结合鼻窦闭塞完全切除黏膜。在这些情况下,需要进行外部额窦手术。

患者/方法:回顾了35例骨成形性鼻窦切开术和5例使用多孔聚乙烯进行的前额重建手术的手术方法和结果。中位随访时间为3.7年,范围为1至7年。手术适应症包括创伤(12例)、感染(8例)、肿瘤(11例)、黏液囊肿或脓性囊肿(4例)以及额部畸形(5例)。

结果

总体功能和美学效果极佳。未发现复发性感染。到目前为止,没有患者需要进行翻修手术,也没有发生严重并发症。12例患者(30%)报告有前额感觉异常。3例患者(7.5%)出现暂时性复视。

结论

由于鼻窦暴露最佳且切口有利,骨成形性额窦切开术可带来极佳的功能和美学效果。与其他植入物相比,多孔聚乙烯具有优越的材料性能,似乎是目前前额重建的首选材料。

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