Huang Q, Zhou B, Cui S J, Li Y C
Department of Otolaryngology Head and Neck Surgery,Beijing Tongren Hospital,Capital Medical University,Beijing,100730,China.
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2016 Aug 20;30(16):1265-1270. doi: 10.13201/j.issn.1001-1781.2016.16.002.
A retrospective study aimed to investigate the characteristics and prognosis of inflammatory sphenoid sinus diseases and discuss of endoscopic surgical techniques.A total of 105 subjects with isolated inflammatory sphenoid pathologies were treated by endoscopic surgery,which included 41(39.0%) cases of fungal sinusitis,33(31.4%) mucocele,and 31(29.5%) sphenoiditis.They were evaluated by paranasalsinuse CT scan and all patients underwent endoscopic sphenoidsinus surgery under general anesthesia.Twenty cases were selected in Messerklinger,74 cases selected in Wingand,5 cases selected in Draf 3-like,5 cases selected in transphenoidal septum into the contralateral sphenoid sinus,and 1 case selected in trans-medial plate of pterygoid process approach.The postoperative follow up from 6 to 27 months showed that sphenoid ostium were good in 96(91.4%) patients,stenosis in 5(4.8%) patients,and atresia in 4(3.8%)patients who need reoperation.Transnasal endoscopic sphenoidectomy should be the standard option for dealing with isolated inflammatory sphenoid diseases.The five different approaches would be selected according to the extension of the diseases and anatomic structure of the sphenoid sinus.
一项回顾性研究旨在调查炎性蝶窦疾病的特征和预后，并探讨内镜手术技术。共有105例孤立性炎性蝶窦病变患者接受了内镜手术治疗，其中真菌性鼻窦炎41例（39.0%），黏液囊肿33例（31.4%），蝶窦炎31例（29.5%）。通过鼻窦CT扫描对他们进行评估，所有患者均在全身麻醉下接受内镜蝶窦手术。Messerklinger术式选择20例，Wingand术式选择74例，类似Draf 3术式选择5例，经蝶窦隔进入对侧蝶窦选择5例，经翼突内侧板入路选择1例。术后随访6至27个月显示，96例（91.4%）患者蝶窦开口良好，5例（4.8%）患者狭窄，4例（3.8%）患者闭锁，后者需要再次手术。经鼻内镜蝶窦切除术应是处理孤立性炎性蝶窦疾病的标准选择。应根据疾病的扩展情况和蝶窦的解剖结构选择五种不同的手术入路。
