ENT-1 Department, Ankara Ataturk Training and Research Hospital, Bilkent Yolu No: 3 Çankaya, Ankara, 06800, Turkey.
Eur Arch Otorhinolaryngol. 2011 Apr;268(4):569-73. doi: 10.1007/s00405-010-1427-4. Epub 2010 Nov 26.
The purpose of this study was to determine the effect of uncinectomy without sinusotomy and natural ostial dilatation on maxillary sinus ventilation in chronic rhinosinusitis. Twenty patients with chronic rhinosinusitis were included in this study. The patients were randomly divided into two groups. Group 1 consisted of patients with uncinectomy (n = 10), while group 2 was made up of patients treated with natural ostial dilatation (n = 10). The CO(2) tension and pressure levels of the maxillary sinus during inspiration and expiration phases were obtained and compared before and after the procedures within and between the groups. The mean CO(2) tension levels in both groups were significantly decreased after the procedures. The mean maxillary sinus pressure during inspiration was significantly decreased to a negative value after uncinectomy; however, no significant change was observed during expiration. There were no significant changes in maxillary sinus pressures after natural ostial dilatation procedure. Both uncinectomy and natural ostial dilatation seem to be equally effective in decreasing maxillary sinus pCO(2) levels. The effects of decreased maxillary sinus pressure during inspiration after uncinectomy on mucociliary clearance and development mechanisms of chronic rhinosinusitis seem to be worth investigating.
本研究旨在探讨不施行上颌窦窦口切开而单纯行钩突切除术和自然口扩大术对上颌窦通气功能的影响。选择慢性鼻窦炎患者 20 例，随机分为两组。A 组行钩突切除术（n=10），B 组行自然口扩大术（n=10）。分别于术前后测定患者上颌窦在呼吸周期内的 CO2 张力和压力水平，并进行组内及组间比较。两组患者术后上颌窦内 CO2 张力均明显降低。A 组术后上颌窦进气相压力明显下降至负值，但出气相压力无明显变化。B 组术后上颌窦压力无明显变化。钩突切除术和自然口扩大术均可有效降低上颌窦内 CO2 张力。钩突切除术后上颌窦进气相压力降低对上颌窦黏膜纤毛清除功能的影响及其与慢性鼻窦炎发病机制的关系值得进一步研究。
