Peng Zhouying, Wang Yumin, Fang Yan, Wang Yaxuan, Chen Xiang, Fan Ruohao, Zhang Hua, Xie Zhihai, Jiang Weihong
Department of Otolaryngology Head and Neck Surgery, Xiangya Hospital, Central South University, Changsha, China.
Otolaryngology Major Disease Research Key Laboratory of Hunan, Changsha, China.
Front Surg. 2022 Apr 25;9:862178. doi: 10.3389/fsurg.2022.862178. eCollection 2022.
The endoscopic endonasal approach to removing lesions in the nasal cavity and sinuses has become the modern first choice. However, if endoscopic surgery is performed without proper knowledge of sinus anatomy, there is a risk of residual lesions, recurrence, and even serious complications. Therefore, this article illustrates the importance of precise sinus opening guided by the natural sinus drainage pathway, using the anatomy of the frontal sinus (FS) and the frontal recess (FR) cells as an example.
A total of 82 sides cadaveric heads were dissected and analyzed, and the natural drainage pathways of the FR cells and FS were observed at 0°and 70°nasal endoscopic views, and the findings were summarized. The data of 79 patients who accepted endonasal endoscopic surgery (EES) guided by natural sinus drainage pathways to remove mucoceles in our department from January 2015 to January 2021 were retrospectively analyzed.
Two natural drainage pathways of the FR cells were discovered, identified, and named the medial pathway of the FR (MPFR) and the lateral pathway of the FR (LPFR). The 79 patients who accepted EES to remove mucoceles through the natural drainage pathways of FR cells and the FS showed significant improvement in clinical symptoms, and none of them had recurrence after surgery without serious complications.
The EES of the FR cells and FS through the natural drainage pathways to remove the mucoceles facilitates exposure of the cells without residual lesions and without serious complications.
经鼻内镜鼻内入路切除鼻腔和鼻窦病变已成为现代首选方法。然而，如果在不了解鼻窦解剖结构的情况下进行内镜手术，存在残留病变、复发甚至严重并发症的风险。因此，本文以额窦（FS）和额隐窝（FR）气房的解剖结构为例，阐述了以自然鼻窦引流途径为导向精确打开鼻窦的重要性。
共解剖分析82侧尸体头部，在0°和70°鼻内镜视野下观察FR气房和FS的自然引流途径，并总结观察结果。回顾性分析2015年1月至2021年1月在我科接受以自然鼻窦引流途径为导向的鼻内镜手术（EES）切除黏液囊肿的79例患者的数据。
发现并确定了FR气房的两条自然引流途径，分别命名为FR内侧途径（MPFR）和FR外侧途径（LPFR）。79例通过FR气房和FS的自然引流途径接受EES切除黏液囊肿的患者临床症状明显改善，术后均无复发且无严重并发症。
通过自然引流途径对FR气房和FS进行EES切除黏液囊肿，有利于气房暴露，无残留病变且无严重并发症。
