Becker Samuel S, Roberts Deanne M, Beddow Peter A, Russell Paul T, Duncavage James A
Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, TN 37232-8605, USA.
Ear Nose Throat J. 2011 Jun;90(6):262-6. doi: 10.1177/014556131109000607.
The cases of 80 patients who underwent Caldwell-Luc surgery for the treatment of chronic rhinosinusitis between 2002 and 2007 at Vanderbilt University Medical Center's Department of Otolaryngology were reviewed. Data on demographics, comorbidities, details of surgery, surgical pathology, and histology were collected. These data were compared with those of 40 patients who underwent standard functional endoscopic sinus surgery in 2007. Statistically significant differences were found in terms of mean patient age, sex, mean number of sinuses surgically addressed, number of prior surgeries, and tissue eosinophil counts. Microscopic examination revealed the presence of "necrotic bone" in 2 Caldwell-Luc specimens, and "necrotic debris" in 2 other Caldwell-Luc specimens. No similar finding was seen in the control group. Caldwell-Luc is a surgery of last resort for patients who fail aggressive interventions for maxillary sinus disease. The mucosal lining of this small group of patients appears to be different from that of patients who respond favorably to functional endoscopic sinus surgery.
回顾了2002年至2007年间在范德比尔特大学医学中心耳鼻喉科接受考德威尔-卢氏手术治疗慢性鼻-鼻窦炎的80例患者的病例。收集了有关人口统计学、合并症、手术细节、手术病理和组织学的数据。将这些数据与2007年接受标准功能性鼻内镜鼻窦手术的40例患者的数据进行了比较。在平均患者年龄、性别、手术治疗的鼻窦平均数量、既往手术次数和组织嗜酸性粒细胞计数方面发现了统计学上的显著差异。显微镜检查显示，2例考德威尔-卢氏手术标本中存在“坏死骨”，另外2例考德威尔-卢氏手术标本中存在“坏死碎片”。对照组未发现类似情况。考德威尔-卢氏手术是对上颌窦疾病积极干预失败的患者的最后手段。这一小部分患者的黏膜内衬似乎与对功能性鼻内镜鼻窦手术反应良好的患者不同。
