Department of Otorhinolaryngology, University Medical Center, Kirrberger Straße, 66421, Homburg/Saar, Germany,
Eur Arch Otorhinolaryngol. 2014 Feb;271(2):287-92. doi: 10.1007/s00405-013-2531-z. Epub 2013 Apr 30.
Endoscopic frontal sinus surgery requires special attention to the numerous anatomical variations. Additionally, in situations of revision surgery, endonasal frontal sinus identification may be challenging. Numerous strategies have been described to access the frontal sinus in endonasal endoscopic frontal sinus surgery including an additional external approach. A pilot study is presented using a newly designed modular mini-endoscope (1.1 mm, 10.000 pixel, 2 working channels and 120° lens) to assist the frontal sinus surgery through a transcutaneous puncture of the frontal sinus. We used this mini-endoscope for primary frontal sinus surgery on 3 patients and for revision frontal sinus surgery on 4 patients. In all patients, the mini-endoscope could be placed in the frontal sinus without side effects. The visible illumination at the frontal sinus floor, caused by the mini-endoscope being in the frontal sinus, guided the surgeon endonasally directly to the frontal sinus floor. Frontal sinus drainage was achieved by the described guidance on all patients. In conclusion, mini-endoscopy of the frontal sinus might be an interesting option in endoscopic frontal sinus surgery to guide the surgeon by illumination in complex anatomical situations to the frontal sinus. This technique will contribute to further improvement in endonasal endoscopic frontal sinus surgery.
内窥镜额窦手术需要特别注意众多的解剖变异。此外，在翻修手术中，鼻内额窦的识别可能具有挑战性。已经描述了许多策略来在内窥镜鼻窦内窥镜额窦手术中进入额窦，包括额外的外部方法。提出了一项使用新设计的模块化微型内窥镜（1.1 毫米，10000 像素，2 个工作通道和 120°镜头）通过经皮额窦穿刺辅助额窦手术的初步研究。我们在 3 例原发性额窦手术和 4 例额窦翻修手术中使用了这种微型内窥镜。在所有患者中，微型内窥镜均可无副作用地置于额窦中。微型内窥镜位于额窦中引起的额窦底部可见照明，引导外科医生经鼻内直接到达额窦底部。通过描述的引导，所有患者的额窦引流均得以实现。总之，微型内窥镜鼻窦术可能是内窥镜鼻窦手术中一种有趣的选择，可通过照明在复杂的解剖情况下引导外科医生进入额窦。该技术将有助于进一步改进鼻内内窥镜额窦手术。
