Kennedy D W, Zinreich S J, Shaalan H, Kuhn F, Naclerio R, Loch E
Laryngoscope. 1987 Aug;97(8 Pt 3 Suppl 43):1-9. doi: 10.1288/00005537-198708002-00001.
Ostial obstruction is a major factor in the pathogenesis of sinusitis. Detailed diagnostic evaluation in patients with maxillary sinusitis demonstrates the prominence of disease in the ethmoidal infundibulum and in adjacent ethmoid cells. Surgical procedures performed to improve maxillary sinusitis by inferior meatal antrostomy leave residual disease in the ostiomeatal area and may result in persistent mucociliary obstruction. Historically, the possibility of closure following ostial manipulation and the importance of dependent drainage of the maxillary sinus have been cited as arguments against the middle meatal approach. In this study of middle meatal antrostomies the patency rate was 98% between 4 and 32 months. The postoperative endoscopic findings and symptomatic improvement suggest that mucociliary clearance occurs through the surgically widened ostium. We conclude that endoscopic middle meatal antrostomy does not lead to ostial stenosis.
窦口阻塞是鼻窦炎发病机制中的一个主要因素。对上颌窦炎患者进行的详细诊断评估表明，筛漏斗及相邻筛窦气房的病变较为突出。通过下鼻道开窗术改善上颌窦炎的手术操作会在窦口鼻道区域留下残余病变，并且可能导致持续性黏液纤毛阻塞。从历史上看，窦口操作后闭塞的可能性以及上颌窦依赖引流的重要性被认为是反对中鼻道手术入路的理由。在这项关于中鼻道开窗术的研究中，4至32个月间的通畅率为98%。术后的内镜检查结果和症状改善表明，黏液纤毛清除是通过手术扩大的窦口进行的。我们得出结论，内镜下中鼻道开窗术不会导致窦口狭窄。
