Fan J G, Chen L, Li J X, Gu Q J, Li D B, Zhao L B, He G
Department of Otorhinolaryngology Head and Neck Surgery, Sichuan Academy of Medical Science and Sichuan Provincial People's Hospital,Chengdu,610072,China.
Department of Ophthalmology, Sichuan Academy of Medical Science and Sichuan Provincial People's Hospital.
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2016 Aug 5;30(15):1210-1214. doi: 10.13201/j.issn.1001-1781.2016.15.008.
To explore the indications and characteristics for the treatment of nose-eye correlated diseases with endoscopic surgery through external nasal incision combined with nasal cavity approach.The clinical data of 13 patients whom hospitalized in our department and treated by endoscopic surgery through external nasal incision combined with nasal cavity approach since October 2011, were retrospectively analyzed and the characteristics of different pathological changes, clinical manifestations, surgical approach and follow-up results were summarized.Four cases of patients underwent endoscopic surgery through nasal cavity and lacrimal caruncle conjunctival incision, 4 cases received bone fracture reduction and DCR with endoscope through double path of nasal cavity and the original trauma wound, 2 cases with endoscopic bone tumor resection through nasal cavity and external nasal incision, the rest of the 3 cases with endonasal endoscopic and peri-orbit incision surgery.Two cases of tumor patients showed no recurrence followed up for 1.5 to 2 years; the diplopia disappeared in 2 cases of orbital medial wall fracture; surgeries of 4 cases of orbital wall fracture with lacrimal duct obstruction patients, 3 cases succeeded, 1 case failed and change into dacryocystorhinotomy with external nasal incision, and epiphora of all patients vanished; all of the patients of sinus osteoma, foreign bodies and abscess were cured and symptoms disappeared; the symptoms of ectopic meningioma patient gradually died down with eyebrow scars left.The surgery with external nasal incision combined with nasal cavity approach through endoscope to treat noseeye correlated diseases can effectively deal with relevant pathological changes, with the advantages of clear operation field and less damage, but its exact indications and surgical methods still need to be further explored.
探讨经鼻外切口联合鼻腔入路鼻内镜手术治疗鼻眼相关疾病的适应证及特点。回顾性分析2011年10月以来我院收治的13例经鼻外切口联合鼻腔入路鼻内镜手术治疗的患者临床资料，总结不同病变的病理特点、临床表现、手术方式及随访结果。其中4例行鼻腔泪阜结膜切口鼻内镜手术，4例经鼻腔及原外伤创口双路径鼻内镜下骨折复位及泪囊鼻腔造孔术，2例行鼻腔联合鼻外切口鼻内镜下骨肿瘤切除术，其余3例行鼻内镜联合眶周切口手术。2例肿瘤患者随访1.5～2年无复发；2例眶内侧壁骨折患者复视消失；4例眶壁骨折伴泪道阻塞患者手术，3例成功，1例失败后改行鼻外切口泪囊鼻腔吻合术，所有患者溢泪消失；鼻窦骨瘤、异物及脓肿患者均治愈，症状消失；异位脑膜瘤患者症状逐渐缓解，遗留眉弓瘢痕。经鼻外切口联合鼻腔入路鼻内镜手术治疗鼻眼相关疾病能有效处理相关病变，具有术野清晰、损伤小等优点，但确切的适应证及手术方式仍需进一步探索。
