Sun Yan, Zhang Qingquan, Song Xicheng, Zhang Hua, Wang Qiang, Liu Zhonglu
Department of Otorhinolaryngology-Head and Neck Surgery, Yuhuangding Hospital of Yantai, Yantai, 264000, China.
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2013 Jan;27(2):57-60.
Research for surgical methods and experience of sinus fibrous dysplasia treatment by auxiliary nasal endoscopy image navigation.
Retrospective analysis of the records of 4 patients from March 2006 to December 2011 who were diagnosed as fibrous dysplasia of nasal sinuses, 2 male and 2 female, aged from 19 yrs to 55 yrs and average age was 38 yrs; 3 of them were destroyed of sinus floor, the other who had the bone fiber of sphenoidal sinus. By using 16 multi slice spiral CT and 3D reconstruction, the 4 cases were all treated by drill grinding abnormal fibrous tissue in the nasal sinus cavities with auxiliary nasal endoscopy image navigation, to achieve contour in the bone fiber cavities.
Lesions of 4 cases were accurately found and grinded under auxiliary nasal endoscopy image navigation. For 3 patients, headache, nasal congestion, facial discomfort and other symptoms have gradually disappeared after operation. However, one patient with sinus floor destroyed suffered facial swelling and pain 3 month after operation, with ineffective conservation treatment outcomes. After CT re-scan, it showed that there were a large number of bone residue in maxillary sinus during the re-operation. The reason was that the surgical cavity was not rinsed off which leaded to maxillary sinus congestion. With the methods of expansion of the maxillary sinus, flushing the cavity, and postoperative nasal and maxillary sinus rinse, symptoms disappeared 1 month later without recurrence.
Patients with fibrous dysplasia of nasal sinuses are treated thoroughly, securely, and effectually, by drill grinding abnormal fibrous tissue in the nasal sinus cavities with auxiliary nasal endoscopy image navigation, to achieve contour in the bone fiber cavities.
探讨辅助鼻内镜影像导航下鼻窦骨纤维异常增殖症的手术方法及经验。
回顾性分析2006年3月至2011年12月期间确诊为鼻窦骨纤维异常增殖症的4例患者资料,男2例,女2例,年龄19~55岁,平均38岁;其中3例为鼻窦底骨质破坏,1例为蝶窦骨纤维异常增殖。4例均采用16排螺旋CT及三维重建,在辅助鼻内镜影像导航下磨除鼻窦腔内异常纤维组织,使骨纤维腔形态规整。
4例患者在辅助鼻内镜影像导航下均准确找到病变并磨除。3例患者术后头痛、鼻塞、面部不适等症状逐渐消失。1例鼻窦底骨质破坏患者术后3个月出现面部肿胀、疼痛,保守治疗效果不佳。CT复查显示再次手术时上颌窦内有大量骨质残留,原因是手术腔未冲洗干净导致上颌窦积血。经扩大上颌窦开口、冲洗窦腔及术后鼻腔、上颌窦冲洗等处理,1个月后症状消失,未再复发。
辅助鼻内镜影像导航下磨除鼻窦腔内异常纤维组织,使骨纤维腔形态规整,可安全、有效、彻底地治疗鼻窦骨纤维异常增殖症。