Zhu Sheng-hua, He Guang-xiang, Sun Hong, Ma Yan-Hong, Liu Guo-hui, Jiang Ming
Department of Otorhinolaryngology, Third Xiangya Hospital, Central South University, Changsha, China.
Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2006 Apr;31(2):208-11.
To investigate the causes of revision endoscopic sinus surgery (RESS), and to evaluate the clinical effect and experience of RESS in the patients with recurrent sinusitis.
Before the revision surgery, 168 patients (225 sides) with recurrent sinusitis were examed by CT scans and nasal endoscopy. All patients were operated by revision endoscopic sinus surgery.
Among the 168 patients, 95 cases (121 sides) had incomplete middle turbinate, 51 cases (75 sides) had maxillary sinus ostium stenosis, 85 cases (117 sides) had nasal cavity adhesion, 48 cases (57 sides) had uncinate process residual, 38 cases (65 sides) had ethmoid hyperostosis, and 25 cases had nasal septum deviation. One hundred and six patients (134 sides) were cured, 40 patients (56 sides) were improved, useful 22 patients (35 sides) were ineffective.
The most common surgical causes of failures in endoscopic sinus surgery are the disease area remnant, nasal cavity adhesion, maxillary sinus ostium stenosis, uncinate process residual, ethmoid hyperostosis, and nasal septum deviation. Revision endoscopic sinus surgery is a useful way to treat recurrent sinusitis. Preoperative CT scan, correct choice of the anatomic marks of orientation and direction function are the key to operation successful.
探讨修正性鼻内镜鼻窦手术（RESS）的原因，并评估RESS治疗复发性鼻窦炎患者的临床效果及经验。
对168例（225侧）复发性鼻窦炎患者在修正手术前进行CT扫描和鼻内镜检查。所有患者均接受修正性鼻内镜鼻窦手术。
168例患者中，95例（121侧）中鼻甲不全，51例（75侧）上颌窦口狭窄，85例（117侧）鼻腔粘连，48例（57侧）钩突残留，38例（65侧）筛窦骨质增生，25例鼻中隔偏曲。106例（134侧）治愈，40例（56侧）好转，22例（35侧）无效。
鼻内镜鼻窦手术失败最常见的手术原因是病变区域残留、鼻腔粘连、上颌窦口狭窄、钩突残留、筛窦骨质增生及鼻中隔偏曲。修正性鼻内镜鼻窦手术是治疗复发性鼻窦炎的有效方法。术前CT扫描、正确选择解剖标志定位及定向操作是手术成功的关键。
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