Gao Minghua, Fang Hongyan
Chongqing Third People's Hospital, Chongqing 400014.
Lin Chuang Er Bi Yan Hou Ke Za Zhi. 2002 Aug;16(8):416-7.
To evaluate the anesthetic method and the prevention of the ophthalmic complication in endoscopic surgery for sphenoid sinus disease.
All 65 patients underwent local anesthesia with improved surface anesthesia. Arrest blood completely in the surgical operation. The position of sphenoid sinus, the assimilation and destruction of sinus wall, the location and the appearance of lesion were determined carefully. To avoid damaging the optic nerve, the behavior of eyes was observed intently.
The follow up period ranged from 6 months to 2 years. Five patients were lost to follow up. 53 of 60 patients recovered. 7 patients had recurrence among them with 2 cases of inverted papilloma and 5 cases of spheniod sinusitis with nose polyp, but they were successfully resected by endoscopic endonasal sinus surgery. Ophthalmic complication occurred in 5 patients.
Endoscopic sphenoid sinus surgery can be performed successfully under local anesthesia with improved surface anesthesia. Familiarity with the anatomic marker and variable anatomy, and meticulous surgical technique are essential for reducing ophthalmic complication.
评估蝶窦疾病内镜手术的麻醉方法及眼部并发症的预防。
65例患者均采用改良表面麻醉下的局部麻醉。手术操作中彻底止血。仔细确定蝶窦的位置、窦壁的同化和破坏情况、病变的位置及外观。为避免损伤视神经，密切观察眼部情况。
随访时间为6个月至2年。5例失访。60例患者中53例康复。其中7例复发，2例为内翻性乳头状瘤，5例为蝶窦炎伴鼻息肉，但均经鼻内镜鼻窦手术成功切除。5例患者出现眼部并发症。
改良表面麻醉下的局部麻醉可成功进行内镜蝶窦手术。熟悉解剖标志和变异解剖结构以及细致的手术技巧对于减少眼部并发症至关重要。
