Miłoński Jarosław, Pietkiewicz Piotr, Olszewski Jurek
Klinika Otolaryngologii i Onkologii Laryngologicznej II Katedry Otolaryngologii UM w Łodzi Kierownik Katedry i Kliniki.
Otolaryngol Pol. 2011 Jan-Feb;65(1):14-9. doi: 10.1016/S0030-6657(11)70622-9.
The aim of the study was to evaluate the results and 4-year own experience in the endoscopic treatment of the nose and paranasal sinuses.
In the Clinic of Otolaryngology and Laryngological Oncology of the Medical University of Lodz between 2006 and 2009 there were 603 endoscopic operations performed on patients with chronic paranasal sinusitis, including 287 females aged 17-80 and 316 males aged 18-87. The patients were qualified for the operation on the basis of an interview, objective otorhinolaryngological examination, frontal and transverse computerized tomography of the nose and paranasal sinuses, laboratory tests (blood cell count, sedimentation tests, urine tests, electrolytes tests). Moreover, allergological diagnostics (skin prick tests, intranasal provocation tests), a histopathological examination of the removed lesions and a culture of biological material from the paranasal sinuses were done. The 0 degree and 30 degrees endoscopes of Storz GMBH and Wolf and the video rotation microtome (debrider).
Possible reasons for paranasal sinusitis were: viral infection (34.8%), anatomical disorders (28.5%), irritating factors like tobacco smoke (17.9%), allergy (13.4%), tumours (3.2%) and gastroesophageal reflux (2.1%). Finally, the following endoscopic operations were conducted: revision surgery of the maxillary sinuses in 680 cases (56.4%), ethmoidectomy in 586 cases (48.6%), polypectomy in 273 cases (22.6%), re-polypectomy in 232 cases (19.2%), sphenoid sinus revision in 229 cases (19.0%), frontal sinus revision in 80 cases (6.6%) and re-ethmoidectomy in 77 cases (6.4%). The average stay in the Clinic lasted 3.2 days.
Advantages of the complex surgical treatment are found in both post-operative and pharmacological procedures. The FESS surgery should be only a minimally invasive technique, which subsequently could guarantee an effective treatment, slight post-operative complications, a short hospitalization period and a quick return of the patient to work, as it is proved by the own study.
本研究旨在评估鼻及鼻窦内镜治疗的结果以及我们自身4年的经验。
在罗兹医科大学耳鼻喉科及喉科肿瘤诊所，2006年至2009年间对慢性鼻窦炎患者进行了603例内镜手术，其中包括287名年龄在17 - 80岁的女性和316名年龄在18 - 87岁的男性。患者通过访谈、客观耳鼻喉科检查、鼻及鼻窦的额面和横断面计算机断层扫描、实验室检查（血细胞计数、血沉检查、尿液检查、电解质检查）来确定是否适合手术。此外，还进行了变应性诊断（皮肤点刺试验、鼻内激发试验）、切除病变的组织病理学检查以及鼻窦生物材料培养。使用了斯托兹股份有限公司和狼牌的0度和30度内镜以及视频旋转切片机（清创器）。
鼻窦炎的可能病因有：病毒感染（34.8%）、解剖结构异常（28.5%）、如烟草烟雾等刺激因素（17.9%）、过敏（13.4%）、肿瘤（3.2%）和胃食管反流（2.1%）。最终，进行了以下内镜手术：上颌窦修正手术680例（56.4%）、筛窦切除术586例（48.6%）、息肉切除术273例（22.6%）、再次息肉切除术232例（19.2%）、蝶窦修正手术229例（19.0%）、额窦修正手术80例（6.6%）和再次筛窦切除术77例（6.4%）。在诊所的平均住院时间为3.2天。
综合手术治疗在术后和药物治疗过程中均有优势。功能性内镜鼻窦手术应仅是一种微创技术，随后可保证有效治疗、轻微的术后并发症、较短的住院时间以及患者快速恢复工作，本研究已证明这一点。
