Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Bern, Switzerland, Freiburgstrasse, 3010 Bern, Switzerland.
Eur Arch Otorhinolaryngol. 2011 Oct;268(10):1463-7. doi: 10.1007/s00405-011-1626-7. Epub 2011 May 11.
Balloon sinuplasty is a tool that is used to treat selected patients with paranasal sinus pathologies. No studies have investigated the aetiology of failed access to the frontal sinus. The aim of our study was to specify the intraoperative technical failure rate and to analyse the aetiology of the failed access to predict potential technical difficulties before surgery. We retrospectively analysed the charts of patients who underwent balloon sinuplasty from November 2007 to July 2010 at three different ENT-Centres. CT-analysis of the patients with failed access was performed. Of the 104 frontal sinuses, dilation of 12 (12%) sinuses failed. The anatomy of all failed cases revealed variations in the frontal recess (frontoethmoidal-cell, frontal-bulla-cell or agger-nasi-cell) or osteoneogenesis. In one patient, a lymphoma was overlooked during a balloon only procedure. The lymphoma was diagnosed 6 months later with a biopsy during functional endoscopic sinus surgery. In complex anatomical situations of the frontal recess, balloon sinuplasty may be challenging or impossible. In these situations, it is essential to have knowledge of classical functional endoscopic sinus surgery of the frontal recess area. The drawbacks of not including a histopathologic exam should be considered in balloon only procedures.
球囊扩张术是一种用于治疗特定鼻窦病变患者的工具。目前尚无研究探讨经鼻内镜额窦开放术失败的病因。我们的研究旨在明确术中技术失败率，并分析经鼻内镜额窦开放术失败的病因，以便在术前预测潜在的技术困难。我们回顾性分析了 2007 年 11 月至 2010 年 7 月在三个不同的耳鼻喉科中心接受球囊扩张术的患者的病历。对经鼻内镜额窦开放术失败的患者进行 CT 分析。在 104 个额窦中，有 12 个（12%）窦腔扩张失败。所有失败病例的解剖结构均显示额隐窝（额筛细胞、额泡细胞或前筛细胞）或骨生成的变异。在 1 例患者中，经球囊扩张术仅忽略了淋巴瘤。6 个月后，在功能性内镜鼻窦手术中进行活检时诊断出淋巴瘤。在额隐窝复杂的解剖结构中，球囊扩张术可能具有挑战性或不可能完成。在这些情况下，了解额窦区域的经典功能性内镜鼻窦手术至关重要。在仅进行球囊扩张术时，不包括组织病理学检查的缺点应予以考虑。
