Ma Jing, He Junling, Zhou Liuqing
Department of Otorhinolaryngology, Generation Hospital of Lanzhou Command, Lanzhou 730050, China.
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2008 Dec;22(23):1071-2.
To study curative effects of endoscopic sinus surgery performed on orbital periosteum abscess.
Application of ceftazidime and vancomycin 24 h later, operation on maxillary sinus and ethmoidectomy were performed under general anesthesia, Meanwhile bacterial culture and drug sensitive test were performed to the purulent secretion from accessory nasal sinuses. Nasal septum and middle turbinate, which hampered the drainage or clearing in nasal cavity, were undertaken operation in same or second stage. After operation 24 h, the wadding in nasal cavity was removed, and the effusion in nasal cavity was suctioned for 2 times daily until wound surface was covered by fresh granulation. Patients were used ceftazidime and vancomycin for 5 days, in which some patients was replaced antibiotics by drug sensitive test.
No complications occurred. Ophthalmagia, expanding of eye and headache were obviously improved, dropsy of blepharon and chemosis were decreased obviously and the movement of eye was increased much. After operation 13 - 22 days, the physical sign in ocular region recovered normal in all patients, no recurrence occurred during a 6 months follow-up, and only 6 patients presented discontinue pain in ocular region.
Endonasal endoscopic surgery for acute orbital of intraorbital abscess is safe and effective technique with obvious privillege.
探讨鼻内镜手术治疗眶骨膜下脓肿的疗效。
应用头孢他啶和万古霉素24小时后,全身麻醉下行上颌窦开放术和筛窦切除术,同时对鼻窦脓性分泌物进行细菌培养和药敏试验。对妨碍鼻腔引流或清理的鼻中隔及中鼻甲,在同一期或二期进行手术。术后24小时取出鼻腔填塞物,每日抽吸鼻腔积液2次,直至创面被新鲜肉芽覆盖。患者应用头孢他啶和万古霉素5天,部分患者根据药敏试验更换抗生素。
无并发症发生。眼痛、眼球突出及头痛明显改善,眼睑水肿及结膜水肿明显减轻,眼球活动度明显增加。术后13 - 22天,所有患者眼部体征恢复正常,随访6个月无复发,仅6例患者眼部遗留间断性疼痛。
鼻内镜下手术治疗眶内急性脓肿是一种安全有效的技术,具有明显优势。