Li M X, Zhang Y C, Zhang W T, Ye H B, Li D W, Su K M
Department of Otorhinolaryngology Head and Neck Surgery, Shanghai Sixth People's Hospital, Shanghai Jiao Tong University, Shanghai, 200233,China.
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2018 Mar;32(5):336-341. doi: 10.13201/j.issn.1001-1781.2018.05.005.
To investigate the effectiveness of balloon catheter dilation (BCD) in the treatment of chronic rhinosinusitis, and to analyse the possible factors which lead to BCD failure, as well as to provide basic reference for BCD clinical usage.Forty-six sinuses of 32 patients with chronic rhinosinusitis were underwent "Balloon-only" BCD or "FESS assisted" BCD at our institution between September 2014 and December 2016. By recording details of the operation of all the subjects in this study and following up the clinical symptoms, nasal endoscopy, computed tomography of the sinuses, and postoperative complications six months after operation, to evaluate the difficulty, safety, effectiveness and especially, the failing reasons of BCD.BCD was approached in 46 sinuses (19 maxillary sinus, 22 frontal and 5 sphenoid), and succeeded in 13 maxillary sinuses, 19 frontal sinuses, and 4 sphenoid sinuses. Of the 13 maxillary sinuses, there were 9 sinuses underwent "Balloon-only" procedure, other 4 cases underwent "FESS assisted" procedure. There were 3 cases of frontal sinus failed, because of the frontal recess anatomical complexity and the twisted drainage. Of the 5 sphenoid sinuses, 4 cases succeeded, including fungal sphenoiditis cases, in which the mould was completely cleared through the dilated ostia, and 1 case failed. All the patients were followed up for 1, 3 and 6 months of patient's quality of life, nasal endoscope, computed tomography of the sinuses. The results showed that the SNOT-20 scores of the quality of life in significant relief of symptoms, nasal mucosa status improved significantly compared with the preoperative, dilated ostium remains open, no obvious scar formation, no severe operative complications.Balloon catheter dilation in the treatment of chronic rhinosinusitis is safe and effective. But the operation indications is limited, and many factors influence the success rate of BCD, so, preoperatively gaining the information of nasal cavity and anatomical structure around ostium according to patients' nasal endoscopy and sinus CT is critical to success of BCD.
探讨球囊导管扩张术（BCD）治疗慢性鼻窦炎的有效性，分析导致BCD失败的可能因素，为BCD临床应用提供基础参考。2014年9月至2016年12月期间，在我院对32例慢性鼻窦炎患者的46个鼻窦进行了“单纯球囊”BCD或“鼻内镜手术辅助”BCD。通过记录本研究中所有受试者的手术细节，并在术后6个月随访临床症状、鼻内镜检查、鼻窦计算机断层扫描及术后并发症，以评估BCD的难度、安全性、有效性，尤其是失败原因。对46个鼻窦（19个上颌窦、22个额窦和5个蝶窦）进行了BCD，其中13个上颌窦、19个额窦和4个蝶窦成功。在13个成功的上颌窦中，9个鼻窦采用“单纯球囊”手术，另外4例采用“鼻内镜手术辅助”手术。有3例额窦手术失败，原因是额隐窝解剖结构复杂及引流扭曲。5个蝶窦中，4例成功，包括真菌性蝶窦炎病例，其中霉菌通过扩张的窦口完全清除，1例失败。对所有患者进行了1、3和6个月的随访，观察患者生活质量、鼻内镜检查、鼻窦计算机断层扫描结果。结果显示，生活质量的SNOT - 20评分中症状明显缓解，鼻黏膜状态较术前明显改善，扩张的窦口保持开放，无明显瘢痕形成，无严重手术并发症。球囊导管扩张术治疗慢性鼻窦炎安全有效。但手术适应证有限，且多种因素影响BCD成功率，因此，术前根据患者鼻内镜检查和鼻窦CT获取鼻腔及窦口周围解剖结构信息对BCD成功至关重要。
