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鼻窦镜手术中的额窦支架置入术:牛津大学 10 年经验。

Frontal sinus stenting in endoscopic sinus surgery: the 10-year Oxford experience.

机构信息

ENT Department, Oxford University Hospital, Oxford, UK.

Department of ENT, Royal National ENT and Eastman Dental Hospitals, London, UK.

出版信息

J Laryngol Otol. 2024 Jan;138(1):60-66. doi: 10.1017/S0022215123000622. Epub 2023 Apr 5.

Abstract

BACKGROUND

Frontal sinus stents have been introduced to reduce frontal sinus re-stenosis after surgery and to improve outcomes.

METHOD

This study was a retrospective analysis of 19 patients who had endoscopic sinus surgery with approach to the frontal sinus and insertion of a soft sinus stent.

RESULTS

The frontal recess was patent in 78.9 per cent and stenosed in 21.1 per cent of patients; no completely closed recesses were observed. Mean follow up was 20.7 months, and time period of stenting was 9.8 months on average; complications were observed in 47.4 per cent of the patients, with post-operative sinonasal infection being the most common.

CONCLUSION

In the authors' experience, indications for frontal sinus stenting include recalcitrant chronic rhinosinusitis after multiple functional endoscopic sinus surgeries (especially in chronic rhinosinusitis with nasal polyps), patients with history of important craniofacial surgery or trauma, and recurrent mucoceles. The stent was overall well tolerated as only minor complications were observed. Close clinical follow up is mandatory.

摘要

背景

鼻窦支架的引入旨在减少术后鼻窦再狭窄,提高手术效果。

方法

本研究回顾性分析了 19 例接受内镜鼻窦手术并进入额窦、置入软性鼻窦支架的患者。

结果

78.9%的患者额隐窝通畅,21.1%的患者额隐窝狭窄;未观察到完全闭锁的隐窝。平均随访时间为 20.7 个月,支架留置时间平均为 9.8 个月;47.4%的患者出现并发症,最常见的是术后鼻-鼻窦炎感染。

结论

作者的经验表明,鼻窦支架置入的适应证包括多次功能性内镜鼻窦手术后仍顽固的慢性鼻-鼻窦炎(尤其是伴有鼻息肉的慢性鼻-鼻窦炎)、有重要头面部手术或外伤史,以及复发性黏液囊肿的患者。支架总体上耐受性良好,仅观察到轻微的并发症。必须进行密切的临床随访。

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