Rudert H
Hals-Nasen-Ohrenklinik, Universität Kiel.
HNO. 1988 Dec;36(12):475-82.
Insights into the importance of the infundibulum of the anterior ethmoid bone in the etiology and pathogenesis of chronic paranasal sinusitis, based above all on the studies of Messerklinger, have resulted in a fundamental change in our concept of therapy: the main objective of any treatment must be the restoration of ventilation and drainage of the paranasal sinuses in the region of the semilunar hiatus. Its function in the healing of paranasal sinus diseases parallels the significance of the Eustachian tube for the healing of inflammatory lesions of the middle ear. In many cases, the objective is attained by infundibulotomy, using Messerklinger's technique. Our technique differs from that described by Messerklinger and Wigand: we use the surgical microscope and a self-retaining nasal speculum. It is thus possible to operate with both hands, as in microsurgery of the ear and the larynx. Moreover, the operations can be taught and learned via an observation tube. Since the introduction of this technique which can be extended at any time to complete endonasal surgery of the maxillary, ethmoid and sphenoid sinuses, extranasal operations on the paranasal sinuses have become exceedingly rare. The results have been checked in a newly established paranasal sinus clinic.
基于梅塞尔克林格的研究，对筛骨前筛漏斗在慢性鼻窦炎病因和发病机制中的重要性的深入了解，导致了我们治疗观念的根本转变：任何治疗的主要目标必须是恢复半月裂孔区域鼻窦的通气和引流。它在鼻窦疾病愈合中的作用与咽鼓管对中耳炎性病变愈合的重要性相当。在许多情况下，通过采用梅塞尔克林格技术进行漏斗切开术可实现这一目标。我们的技术与梅塞尔克林格和维甘德所描述的不同：我们使用手术显微镜和自持式鼻窥器。这样就可以像在耳和喉的显微手术中一样双手操作。此外，这些手术可以通过观察管进行教学和学习。自从引入这种可随时扩展至完成上颌窦、筛窦和蝶窦全鼻内手术的技术以来，鼻窦的鼻外手术已变得极为罕见。这些结果已在新成立的鼻窦诊所得到验证。
