Cannoni M, Zanaret M, Thomassin J M, Scavennec C, Foucault G, Pech A
Ann Otolaryngol Chir Cervicofac. 1985;102(8):545-9.
A lateral fronto-ethmoidal approach simultaneously exposing the frontal sinus and the nasal fossae appears to be a necessity for the surgical treatment of fronto-ethmoidal pathology. It is possible to fashion an osteo-plastic flap in the fronto-naso-maxillary region. The technique of the approach is described. The operation leaves no ocular functional sequelae and the scar is minimal. Twenty one operations by fronto-nasal flap approach are described, 10 for benign tumours of the fronto-ethmoidal system and 11 with the aim of re-aerating the frontal sinus for cases of complicated or iatrogenic serious sinusitis. The results are studied. The indications of the fronto-nasal flap are described: In tumour pathology, this technique must be used for osteomas and mucoceles of the fronto-ethmoidal system as soon as the ethmoidal component reaches or goes beyond the middle ethmoid. If the fronto-ethmoidal lesion only involves the anterior ethmoid, it is then accessible via simple frontal flap. Inverted papillomas which require wide exposure should also be treated via this approach. In infectious pathology, the fronto-nasal flap offers the possibility, after eradication of fronto-ethmoidal lesions and calibration of the naso-frontal canal, of re-aeration of the frontal sinus which seems preferable to its exclusion. The possibility of re-aeration of the frontal sinus by an osteo-plastic procedure is progress in comparison with lost bone craniotomy procedures.
一种同时暴露额窦和鼻腔的外侧额-筛窦入路似乎是额-筛窦病变手术治疗的必要手段。在额-鼻-上颌区域制作骨-塑料瓣是可行的。描述了该入路的技术。该手术不会留下眼部功能后遗症，且瘢痕最小。描述了21例采用额-鼻瓣入路的手术，其中10例用于额-筛窦系统的良性肿瘤，11例旨在为复杂或医源性严重鼻窦炎病例重新开放额窦。对结果进行了研究。描述了额-鼻瓣的适应证：在肿瘤病理学中，一旦筛窦成分到达或超过中筛窦，该技术必须用于额-筛窦系统的骨瘤和黏液囊肿。如果额-筛窦病变仅累及前筛窦，则可通过简单的额瓣进入。需要广泛暴露的内翻性乳头状瘤也应通过该入路治疗。在感染性病理学中，额-鼻瓣在根除额-筛窦病变并校准鼻额管后，为额窦重新开放提供了可能性，这似乎比将其封闭更为可取。与去骨开颅手术相比，通过骨-塑料手术重新开放额窦的可能性是一种进步。
