Department of Otorhinolaryngology, Ghent University Hospital, Ghent, Belgium.
Department of Neurosurgery, Ghent University Hospital, Ghent, Belgium.
Rhinology. 2018 Jun 1;56(2):178-182. doi: 10.4193/Rhin17.078.
Chronic sphenoid sinusitis refractory to both medical therapy and sphenoidotomy requires a more extended intervention based on the principles of salvage surgery. Our aim is to describe the sphenoid drill out technique as a sphenoid salvage intervention and to outline its implications on clinical outcome and quality of life.
12 patients with chronic sphenoiditis undergoing a sphenoid drill out procedure were examined by nasal endoscopy preoperatively and postoperatively for one year. Preoperative and postoperative quality of life questionnaires (RSOM-31 and SF-36) were obtained.
All but one patient had a completely patent neostium without scar formation. No major complications occurred after this procedure. All patients reported at least an improvement of their symptoms, 50% of patients were even symptom free at one year after surgery. The median postoperative RSOM-31 score was significantly lower than the preoperative score. Both the physical component summary (PCS) and the mental component summary (MCS) of the SF-36 score improved significantly. None of the patients needed a revision procedure.
Sphenoid drill out is a safe and effective technique with a high success rate. In patients with chronic sphenoid sinusitis refractory to medical therapy and surgery it could be a valid alternative to revision sphenoidotomy.
慢性蝶窦炎经药物治疗和蝶窦切开术均无效，需要根据挽救性手术的原则进行更广泛的干预。我们旨在描述蝶窦钻削技术作为一种蝶窦挽救性干预措施，并概述其对临床结果和生活质量的影响。
对 12 例慢性蝶窦炎患者行蝶窦钻削术，术前和术后 1 年进行鼻内镜检查。获得术前和术后生活质量问卷（RSOM-31 和 SF-36）。
除 1 例患者外，所有患者的新鼻口均完全通畅，无瘢痕形成。该手术后无重大并发症发生。所有患者均报告症状至少有所改善，50%的患者在手术后 1 年时甚至无症状。术后 RSOM-31 评分中位数明显低于术前评分。SF-36 评分的生理成分综合评分（PCS）和心理成分综合评分（MCS）均显著提高。无患者需要再次手术。
蝶窦钻削术是一种安全有效的技术，成功率高。对于药物治疗和手术无效的慢性蝶窦炎患者，它可能是修正性蝶窦切开术的有效替代方法。
