Puterman M, Segal N, Nash M, Lieberman A
Soroka University Medica Center, Department of Otolaryngology.
Harefuah. 2004 May;143(5):322-6, 392.
Chronic frontal sinusitis is a relatively common condition, yet one with potential for complications. The treatment of chronic frontal sinusitis has always been a challenge for the otolaryngologist, and it remains so even in the age of endoscopic sinus surgery. Successful treatment is evaluated by both subjective (patient history) and objective (radiologic and endoscopic) criteria.
This article aims to present our experience in endoscopic surgery for chronic frontal sinusitis, with particular focus on the importance of the wide opening of the naso-frontal outflow tract, with maximal preservation of the mucosa in this area.
During the period 1999 to 2001, 72 patients at the Soroka University Medical Center underwent endoscopic surgery for chronic frontal sinusitis. We reviewed the cases of fifty four patients of this group with a minimum six months follow-up. Patients who did not return for routine post-operative visits were excluded from this study. We evaluated and quantified subjective measurements including facial pain, nasal respiratory obstruction and hyposmia, and objective measurements, based on radiographic studies and endoscopic examination.
Most patients experienced improvement in all of the subjective categories, and particularly in the categories of facial pain/headache and nasal respiratory obstruction. Most patients who experienced this improvement had suffered from chronic pansinusitis.
The endoscopic management of chronic frontal sinus disease is an effective treatment, when principles of wide sinus drainage with maximal mucosal preservation are observed. Most patients undergoing this type of procedure experience significant clinical and radiologic improvement in their condition.
慢性额窦炎是一种相对常见的病症,但存在引发并发症的可能性。慢性额窦炎的治疗一直是耳鼻喉科医生面临的一项挑战,即便在内镜鼻窦手术时代亦是如此。成功的治疗需依据主观(患者病史)和客观(放射学及内镜检查)标准来评估。
本文旨在介绍我们在内镜治疗慢性额窦炎方面的经验,特别强调鼻额窦引流通道充分开放的重要性,同时最大程度保留该区域的黏膜。
1999年至2001年期间,索罗卡大学医学中心的72例患者接受了慢性额窦炎的内镜手术。我们回顾了该组中54例患者的病例,这些患者至少接受了6个月的随访。未返回进行常规术后复诊的患者被排除在本研究之外。我们基于影像学研究和内镜检查,对包括面部疼痛、鼻呼吸阻塞和嗅觉减退等主观指标以及客观指标进行了评估和量化。
大多数患者在所有主观指标方面都有改善,尤其是在面部疼痛/头痛和鼻呼吸阻塞方面。大多数出现这种改善的患者患有慢性全鼻窦炎。
当遵循鼻窦充分引流且最大程度保留黏膜的原则时,内镜治疗慢性额窦疾病是一种有效的治疗方法。大多数接受此类手术的患者在病情上有显著的临床和影像学改善。