Maeso Patricia A, Deal Robert T, Kountakis Stilianos E
Department of Otolaryngology-Head and Neck Surgery, Medical College of Georgia, Augusta, GA 30912, USA.
Am J Otolaryngol. 2009 Sep-Oct;30(5):337-9. doi: 10.1016/j.amjoto.2008.06.012. Epub 2008 Oct 11.
The aim of the study was to present minimally invasive combined endoscopic and minitrephination techniques in the surgical management of frontal sinus type IV cell disease.
Case report of a 44-year-old man with localized pain in the right forehead. Computed tomography of the sinus revealed an opacified expanding type IV cell within the right frontal sinus, draining into the frontal sinus itself. An endoscopic approach through the frontal recess was not successful in reaching this cell. A minitrephination approach was then used and an endoscope was inserted through the trephination hole. Instruments were inserted endoscopically into the right frontal sinus through the frontal recess and then using direct endoscopic visualization through the minitrephination access, the frontal cell was opened and marsupialized.
The patient recovered uneventfully with his localized frontal pain completely resolved 3 years after surgery.
The minitrephination approach can be used to introduce an endoscope into the frontal sinus to assist in the surgical management of remote cephalad and lateral lesions within the sinus that are otherwise difficult to reach using endoscopic techniques alone.
本研究的目的是介绍在额窦IV型气房疾病手术治疗中微创联合内镜和微型环钻技术。
一名44岁男性患者，右侧前额局部疼痛的病例报告。鼻窦计算机断层扫描显示右侧额窦内有一个不透明的扩张型IV型气房，引流至额窦本身。通过额隐窝的内镜入路未能成功到达该气房。然后采用微型环钻入路，通过环钻孔插入内镜。器械通过额隐窝经内镜插入右侧额窦，然后通过微型环钻入路直接内镜观察，打开额气房并进行袋形造口术。
患者术后恢复顺利，术后3年局部额部疼痛完全缓解。
微型环钻入路可用于将内镜引入额窦，以辅助手术治疗鼻窦内位置偏远的头侧和外侧病变，否则仅用内镜技术难以到达这些病变部位。
