Donald P J, Montgomery W W, Calcaterra T
Department of Otolaryngology, University of California-Davis School of Medicine, Davis-Sacramento Medical Center.
Head Neck Surg. 1987 Sep-Oct;10(1):59-62. doi: 10.1002/hed.2890100110.
For this patient's treatment, all three consultants advise against the Lynch-type frontoethmoidectomy procedure, with or without mucoperiosteal flap reconstruction of the nasofrontal duct. Treatment plan: Culture and sensitivity of pus; 2-3 weeks of intravenous antibiotics followed by osteoplastic flap fat obliteration of frontal sinus; delayed defect repair with methyl methacrylate (Montgomery). Trephination followed by treatment with local and systemic antibiotics (Donald); removal of infected bone and soft tissue (sinus collapse) and delayed defect repair in 6-12 months (Donald, Calcaterra) with metylmethacrylate (Donald) or in situ cured silicone elastomer (Calcaterra).
对于该患者的治疗，三位会诊医生均建议不采用林奇式额窦筛窦切除术，无论是否进行鼻额管黏膜骨膜瓣重建。治疗方案：脓液培养及药敏试验；静脉注射抗生素2 - 3周，随后行额窦骨成形瓣脂肪填塞术；用甲基丙烯酸甲酯（蒙哥马利法）延迟修复缺损。钻孔引流后局部及全身应用抗生素治疗（唐纳德法）；清除感染的骨质和软组织（鼻窦塌陷），6 - 12个月后延迟修复缺损（唐纳德法、卡尔卡特拉法），使用甲基丙烯酸甲酯（唐纳德法）或原位固化硅橡胶（卡尔卡特拉法）。
