Brumund Kevin T, Graham Scott M, Beck Kenneth C, Hoffman Eric A, McLennan Geoffrey
Department of Otolarygology-Head and Neck Surgery, University of Iowa, Iowa City, USA.
Otolaryngol Head Neck Surg. 2004 Oct;131(4):528-33. doi: 10.1016/j.otohns.2004.04.010.
A major goal of maxillary antrostomy is to increase sinus ventilation. Limited data exist regarding the effect of maxillary antrostomy size on sinus ventilation. We sought to quantify the effect of uncinectomy, small antrostomy, and large antrostomy on maxillary sinus ventilation using xenon-enhanced CT in the sheep model. MATERIALS, STUDY DESIGN, AND METHODS: A xenon-oxygen-air mixture was delivered to 8 fresh cadaveric sheep heads while repeated CT scans were performed through the maxillary sinuses. Baseline and postoperative studies were performed after an endoscopic uncinectomy, small antrostomy, or large antrostomy was created. Images were analyzed to measure the density of the xenon gas in the maxillary sinus as a function of time, generating a time constant.
The time constants for both small antrostomy and large antrostomy were significantly different compared to baseline ( P = 0.003 for both). The time constant comparison between small antrostomy and large antrostomy was not significant ( P = 0.948).
A small antrostomy produces a statistically significant increase in maxillary sinus ventilation over baseline. No significant further ventilation increase is obtained by creating a large antrostomy in the sheep model. This lends credence to the use of small antrostomies to improve maxillary sinus ventilation in human sinus surgery.
上颌窦开窗术的一个主要目标是增加鼻窦通气。关于上颌窦开窗大小对鼻窦通气的影响，现有数据有限。我们试图在绵羊模型中使用氙增强CT来量化钩突切除术、小开窗术和大开窗术对上颌窦通气的影响。
材料、研究设计与方法：将氙 - 氧 - 空气混合物输送至8个新鲜的绵羊尸体头部，同时对上颌窦进行重复CT扫描。在内镜下进行钩突切除术、小开窗术或大开窗术后，进行基线和术后研究。分析图像以测量上颌窦内氙气密度随时间的变化，生成一个时间常数。
小开窗术和大开窗术的时间常数与基线相比均有显著差异（两者P = 0.003）。小开窗术和大开窗术之间的时间常数比较无显著差异（P = 0.948）。
在绵羊模型中，小开窗术使上颌窦通气较基线有统计学显著增加。大开窗术并未使通气进一步显著增加。这为在人类鼻窦手术中使用小开窗术改善上颌窦通气提供了依据。
