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[鼻内额窦手术。第1部分:额窦引流,I型和II型]

[Endonasal frontal sinus surgery. Part 1: Frontal sinus drainage, types I and II].

作者信息

Weber R

机构信息

Sektion Nasennebenhöhlen- und Schädelbasischirurgie, Traumatologie derHNO-Klinik, Städtisches Klinikum, Moltkestrasse 90, 76133, Karlsruhe.

出版信息

HNO. 2009 Aug;57(8):739-50. doi: 10.1007/s00106-008-1751-9.

Abstract

Endonasal frontal sinus surgery aims to create adequate access to the frontal sinus, remove specific pathologic processes, and establish a permanent and sufficient drainage and ventilation. We present a concept of frontal sinus surgery that depends on the individual anatomy of the frontal and ethmoid sinuses and includes a stepwise intensity of the surgical procedure. Endonasal frontal sinus drainage according to Draf ranges from uncinectomy to the maximal procedure, type III drainage; these procedures are outlined in detail. A comprehensive overview of technical aspects to optimize the operative technique and postoperative results is given. Surgical details include the application of nasal packing, mitomycin C, mucosal transplants, silicone foils or stents, and the new technology of balloon sinuplasty. Specific instrumentation and endoscopic equipment are recommended. Part 1 deals with types I and II frontal sinus drainage. Part 2 explains type III drainage, technical details, and special aspects of postoperative care.

摘要

鼻内镜下额窦手术旨在充分暴露额窦,清除特定病理病变,并建立持久且充分的引流和通气。我们提出一种额窦手术概念,该概念取决于额窦和筛窦的个体解剖结构,并包括手术步骤的逐步强化。根据Draf分类的鼻内镜下额窦引流范围从不完全切除术到最大程度的手术,即III型引流;这些手术将详细概述。本文还对优化手术技术和术后效果的技术方面进行了全面综述。手术细节包括鼻腔填塞、丝裂霉素C、黏膜移植、硅胶箔或支架的应用,以及球囊鼻窦成形术的新技术。推荐了特定的器械和内镜设备。第1部分讨论I型和II型额窦引流。第2部分解释III型引流、技术细节以及术后护理的特殊方面。

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