Li Zhishen, Shi Guohua, Zhang Shilong
Department of Otolaryngology, Liaocheng People's Hospital, Liaocheng 252000, China.
Lin Chuang Er Bi Yan Hou Ke Za Zhi. 2006 Dec;20(23):1065-8.
To investigate the characteristics of chronic frontal sinusitis and to improve the clinical therapeutic efficacy.
Sixty-eight patients (130 sides) who underwent endoscopic frontal sinus surgery in our department were randomly divided into three groups: Group 1 included 23 patients (43 operations) underwent endonasal sinus surgery with the frontal sinus opened and drained by two pipes of silicone for 6 months. Group 2 included 24 patients (45 operations) treated as group 1 but added injection of beclomethasone (approximately 1 cc, 94 mcg/100 microliters). Group 3 included 21 patients (42 operations) with only frontal sinus opened.
After an average follow-up of 18 months, the cure rate in group 1, group 2 and group 3 was 93%, 93% and 71% respectively.
The ultimate success or failure of frontal sinus surgical procedures, whether they are endonasal or external, depends on the restenosis of the frontal sinus outflow tract or neo-ostium postoperatively. Long-term stenting for a period of several months will significantly reduce the possibility of restenosis. We recommend that this type of management be considered in difficult revision cases and before performing an external operation.
探讨慢性额窦炎的特点并提高临床治疗效果。
将在我科接受鼻内镜额窦手术的68例患者(130侧)随机分为三组:第一组23例患者(43次手术),采用鼻内鼻窦手术,用两根硅胶管开放引流额窦6个月;第二组24例患者(45次手术),手术方式同第一组,但加用倍氯米松注射(约1毫升,94微克/100微升);第三组21例患者(42次手术),仅开放额窦。
平均随访18个月后,第一组、第二组和第三组的治愈率分别为93%、93%和71%。
额窦手术(无论是鼻内手术还是外部手术)最终的成败取决于术后额窦流出道或新开口的再狭窄情况。数月的长期支架置入将显著降低再狭窄的可能性。我们建议在困难的翻修病例和进行外部手术前考虑这种治疗方法。