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[奥地利和瑞士鼻旁窦手术的发展:过去、现在与未来]

[Development of paranasal sinus surgery in Austria and Switzerland: past, present, and future].

作者信息

Vyskocil Erich, Wolf Axel, Hinder Dominik

机构信息

Abteilung für Hals‑, Nasen- und Ohrenkrankheiten, Medizinische Universität Wien, Währinger Gürtel 18-20, 1090, Wien, Österreich.

Praxis HNO Wolf Graz, Graz, Österreich.

出版信息

HNO. 2025 Jan;73(1):45-54. doi: 10.1007/s00106-024-01539-3. Epub 2025 Jan 2.

Abstract

Thanks to our predecessors and technical progress, we can nowadays offer our patients a safe and modern paranasal sinus surgery. This article provides an overview of the historical development of paranasal sinus surgery in Austria and Switzerland and to shed light on the dynamic progress of this discipline in an international context. Paranasal sinus surgery has undergone significant change in recent decades, driven by rapid technological advances that have significantly improved surgical procedures and operative outcomes. While indications were originally limited to treatment of inflammatory diseases, today, endoscopic procedures cover interventions in the area of the anterior skull base, the orbit and sinonasal tumors. The concept of functional endoscopic sinus surgery (FESS) may seem simple, but the anatomic variability, especially in the area of the frontal sinus, as well as the wide spectrum and severity of diseases can be a challenge. Therefore, paranasal sinus surgery should not be a casual operation and should only be performed by well-trained surgeons to prevent disease recurrence as well as medical and economic follow-up costs. Standardized surgical training for aspiring paranasal sinus and skull base surgeons is critical. Preoperative planning through systematic analysis of CT images is an essential factor to achieve optimal results and to avoid intraoperative complications. The pathophysiological understanding of sinonasal disease and the recent developments of new drug therapies such as monoclonal antibodies also enable excellent results in the small subgroup of patients who do not benefit from a combination of surgical rehabilitation and long-term drug therapy. The dynamic development of endoscopic paranasal sinus surgery in recent decades shows the potential of the field for the coming decades.

摘要

多亏了我们的前辈以及技术进步,如今我们能够为患者提供安全且现代化的鼻窦手术。本文概述了奥地利和瑞士鼻窦手术的历史发展,并在国际背景下阐明这一学科的动态进展。近几十年来,鼻窦手术发生了重大变化,这得益于快速的技术进步,这些进步显著改善了手术操作和手术效果。虽然最初手术适应症仅限于治疗炎症性疾病,但如今,内镜手术涵盖了前颅底、眼眶和鼻窦肿瘤领域的干预。功能性内镜鼻窦手术(FESS)的概念看似简单,但解剖结构的变异性,尤其是在额窦区域,以及疾病的广泛范围和严重程度可能是一项挑战。因此,鼻窦手术不应是一项随意的操作,应由训练有素的外科医生进行,以防止疾病复发以及后续的医疗和经济成本。为有抱负的鼻窦和颅底外科医生提供标准化的手术培训至关重要。通过系统分析CT图像进行术前规划是取得最佳效果并避免术中并发症的关键因素。对鼻窦疾病的病理生理理解以及单克隆抗体等新药疗法的最新进展,在一小部分无法从手术康复和长期药物治疗相结合中获益的患者中也能取得出色的效果。近几十年来内镜鼻窦手术的动态发展显示了该领域在未来几十年的潜力。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3c94/11711146/a77fb9b1da55/106_2024_1539_Fig1_HTML.jpg

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