Jiang R S, Tsai D L, Hsu C Y
Department of Otolaryngology, Veterans General Hospital-Taichung, Taiwan, R.O.C.
Zhonghua Yi Xue Za Zhi (Taipei). 1990 Mar;45(3):166-73.
Treatment of chronic paranasal sinusitis (CPS) by functional endoscopic sinus surgery refers to removal of the pathologic tissue which interferes with the physiologic function of the sinuses in the ostiomeatal complex under direct vision by use of endoscopes to restore the ventilation and drainage of the sinuses. While the ventilation and drainage of the sinuses become normal, the lesions of sinus mucosa will recover spontaneously and the function of the sinuses will be restored. From May to August 1988, functional endoscopic sinus surgery was performed in 47 cases based on the operative methods described by Dr. Stammberger. We excised the uncinate process of middle meatus and entered the infundibulum. The pathologic tissue in the frontal recess was removed first. The anterior ethmoid sinus and posterior ethmoid sinus were cleared depending on the excisable extent of the lesion and the sphenoid sinus wound be opened if necessary. Middle meatal antrosomy was finally performed to enlarge the obstructed ostium of the maxillary sinus. Seventeen of them met the criteria: 1. a history of the disease for more than 3 months and not improving or recovering after medical treatment 2. no past history of surgical treatment for CPS 3. the etiology is not dentigerous or septal deviation. Because one patient lost to follow up, sixteen patients constituted the materials of this study. About 80% of patients were improved or asymptomatic. No serious complication occurred in all patients and the most common one was the adhesion between the middle turbinate and the lateral nasal wall.
功能性鼻内镜鼻窦手术治疗慢性鼻窦炎是指在鼻内镜直视下,切除妨碍鼻窦生理功能的病变组织,以恢复鼻窦的通气和引流。当鼻窦的通气和引流恢复正常后,鼻窦黏膜病变可自行恢复,鼻窦功能得以恢复。1988年5月至8月,根据施坦伯格医生描述的手术方法,对47例患者实施了功能性鼻内镜鼻窦手术。我们切除了中鼻道的钩突,进入漏斗部。首先切除额隐窝的病变组织,根据病变可切除范围清理前组筛窦和后组筛窦,必要时开放蝶窦。最后进行中鼻道上颌窦开窗术,扩大阻塞的上颌窦开口。其中17例符合标准:1. 病程超过3个月,经药物治疗无改善或未痊愈;2. 既往无慢性鼻窦炎手术治疗史;3. 病因不是牙源性或鼻中隔偏曲。因1例患者失访,16例患者构成本研究对象。约80%的患者病情改善或无症状。所有患者均未发生严重并发症,最常见的是中鼻甲与鼻外侧壁粘连。