Fiorini Francesca Romana, Nogueira Claudia, Verillaud Benjamin, Sama Anshul, Herman Philippe
Department of Medical and Surgical Pathology, Otorhinolaryngology Unit, Pisa University Hospital, Pisa, Italy.
ENT Department, University Hospitals of Leicester, Leicester, United Kingdom.
Laryngoscope. 2016 Nov;126(11):2428-2432. doi: 10.1002/lary.25947. Epub 2016 Mar 12.
OBJECTIVES/HYPOTHESIS: The Draf IIb aims at widening the frontal sinus drainage in a minimally invasive fashion. However, this technique is associated with a high stenosis rate. Hence, local nasal flaps have been recently introduced or designed to speed up mucosal healing and prevent scarring.
The objective of this study was to present the septoturbinal flap (STF), its use in a Draf IIb, and to examine postoperative outcomes of this procedure.
From an initial pool of 48 patients with frontal sinus disease to be treated with a Draf IIb, we prospectively selected 46 (95.84%) patients, submitted to a Draf IIb with STF in two Institutions, from November 2010 to November 2014. We excluded two cases (4.16%) for which a flap could not be performed for anatomic restrictions. We present the STF technique and describe demographic data, indication for surgery, and surgery type.
Indications for surgery included 24 (52.17%) mucoceles or mucopyoceles, 12 (26.1%) chronic rhinosinusitis, four (8.7%) osteomas, two (4.35%) meningoencephaloceles, and four (8.7%) inverted papillomas. Difficult anatomic conditions were encountered in half of the patients. Restenosis of the frontal sinus drainage pathway occurred in one (2.17%) patient. Far-seated frontal mucoceles recurred in two cases (4.35%), with frontal drainage pathway remaining patent. Rescue treatment comprised a Draf III in two cases and one frontal sinus obliteration. Outcome was favorable for 43 (93.5%) patients.
The use of STF was associated with a high rate of success for a Draf IIb.
目的/假设：Draf IIb手术旨在以微创方式扩大额窦引流。然而，该技术的狭窄率较高。因此，最近引入或设计了局部鼻瓣以加速黏膜愈合并防止瘢痕形成。
本研究的目的是介绍鼻中隔鼻甲瓣（STF）及其在Draf IIb手术中的应用，并检查该手术的术后结果。
从最初的48例拟接受Draf IIb手术治疗的额窦疾病患者中，我们前瞻性地选择了46例（95.84%）患者，于2010年11月至2014年11月在两家机构接受了带STF的Draf IIb手术。我们排除了2例（4.16%）因解剖限制无法进行瓣手术的病例。我们介绍了STF技术，并描述了人口统计学数据、手术指征和手术类型。
手术指征包括24例（52.17%）黏液囊肿或黏液脓性囊肿、12例（26.1%）慢性鼻-鼻窦炎、4例（8.7%）骨瘤、2例（4.35%）脑膜脑膨出和4例（8.7%）内翻性乳头状瘤。一半的患者遇到了困难的解剖条件。1例（2.17%）患者出现额窦引流通道再狭窄。2例（4.35%）远处额部黏液囊肿复发，额窦引流通道保持通畅。补救治疗包括2例Draf III手术和1例额窦闭塞术。43例（93.5%）患者预后良好。
STF的应用使Draf IIb手术成功率较高。
4。《喉镜》，2016年，第126卷，第2428 - 2432页。
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