Felippu Alexandre
Felippu Institute, São Paulo, Brazil.
Ann Otol Rhinol Laryngol. 2011 Sep;120(9):581-5. doi: 10.1177/000348941112000905.
My aim in this article is to report 26 years of experience in order to evaluate the applicability and efficiency of centripetal dissection in intranasal ethmoid sinus surgery.
I performed a retrospective review of 2,500 patients treated in the Felippu Institute, São Paulo, over the 26-year period from 1984 to July 2010. All of the patients underwent intranasal ethmoid sinus surgery with the centripetal technique. Before surgery, an otolaryngological examination, nasal endoscopy, and computed tomographic scans with axial, coronal, and sagittal projections were performed. All surgeries were carried out under general anesthesia and with the help of a surgical microscope or (after 1997) a rigid 30 degrees endoscope. The surgical technique required a standard endoscopic sinus surgery set. The complications of intranasal ethmoid sinus surgery were recorded and classified as intraoperative, short-term, or long-term.
I observed an intraoperative complication (cerebrospinal fluid leak) in 4 patients. There were no cases of periorbital damage. I recorded no short-term or long-term complications. All of the intraoperative complications were resolved during surgery.
With the use of this technique, the surgeon can precisely identify the position of the surgical instrument without losing his or her orientation, and thereby significantly reduce the risk of complications.
本文旨在报告26年的经验，以评估向心性剥离术在鼻内筛窦手术中的适用性和有效性。
我对1984年至2010年7月在圣保罗费利普研究所接受治疗的2500例患者进行了回顾性研究。所有患者均采用向心性技术进行鼻内筛窦手术。手术前，进行了耳鼻喉科检查、鼻内镜检查以及轴向、冠状和矢状位的计算机断层扫描。所有手术均在全身麻醉下进行，并借助手术显微镜或（1997年后）30度硬性内镜。手术技术需要一套标准的鼻内镜鼻窦手术器械。记录鼻内筛窦手术的并发症，并分为术中、短期或长期并发症。
我观察到4例患者出现术中并发症（脑脊液漏）。没有眶周损伤的病例。我记录到没有短期或长期并发症。所有术中并发症均在手术过程中得到解决。
使用该技术，外科医生可以在不迷失方向的情况下精确确定手术器械的位置，从而显著降低并发症的风险。
