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鼻腔填塞与支架置入

Nasal packing and stenting.

作者信息

Weber Rainer K

机构信息

Sektion Nasennebenhöhlen- und Schädelbasischirurgie, Traumatologie, HNO-Klinik, Städtisches Klinikum Karlsruhe, Germany.

出版信息

GMS Curr Top Otorhinolaryngol Head Neck Surg. 2009;8:Doc02. doi: 10.3205/cto000054. Epub 2011 Mar 10.

Abstract

Nasal packs are indispensable in ENT practice. This study reviews current indications, effectiveness and risks of nasal packs and stents. In endoscopic surgery, nasal packs should always have smooth surfaces to minimize mucosal damage, improve wound healing and increase patient comfort. Functional endoscopic endonasal sinus surgery allows the use of modern nasal packs, since pressure is no longer required. So called hemostatic/resorbable materials are a first step in this direction. However, they may lead to adhesions and foreign body reactions in mucosal membranes. Simple occlusion is an effective method for creating a moist milieu for improved wound healing and avoiding dryness. Stenting of the frontal sinus is recommended if surgery fails to produce a wide, physiologically shaped drainage path that is sufficiently covered by intact tissue.

摘要

鼻腔填塞物在耳鼻喉科实践中不可或缺。本研究回顾了鼻腔填塞物和支架的当前适应证、有效性及风险。在内镜手术中,鼻腔填塞物表面应始终光滑,以尽量减少黏膜损伤、促进伤口愈合并提高患者舒适度。功能性鼻内镜鼻窦手术允许使用现代鼻腔填塞物,因为不再需要施加压力。所谓的止血/可吸收材料是朝这个方向迈出的第一步。然而,它们可能导致黏膜粘连和异物反应。单纯填塞是创造湿润环境以促进伤口愈合和避免干燥的有效方法。如果手术未能形成一个足够宽、具有生理形态且有完整组织充分覆盖的引流通道,则建议对额窦进行支架置入。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/54f4/3199821/43e8cdf3bc4b/CTO-08-02-t-001.jpg

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